|
HC TUBE TRACH NASAL 5.0MM
|
Facility
IP
|
$52.07
|
|
| Hospital Charge Code |
901698723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$46.86 |
| Rate for Payer: Cash Price |
$23.43
|
| Rate for Payer: Central Health Plan Commercial |
$41.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.83
|
| Rate for Payer: Galaxy Health WC |
$44.26
|
| Rate for Payer: Global Benefits Group Commercial |
$31.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.05
|
| Rate for Payer: Networks By Design Commercial |
$33.85
|
| Rate for Payer: Prime Health Services Commercial |
$44.26
|
|
|
HC TUBE TRACH NASAL 5.0MM
|
Facility
OP
|
$52.07
|
|
| Hospital Charge Code |
901698723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$46.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$28.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.76
|
| Rate for Payer: BCBS Transplant Transplant |
$31.24
|
| Rate for Payer: Blue Shield of California Commercial |
$32.75
|
| Rate for Payer: Blue Shield of California EPN |
$25.46
|
| Rate for Payer: Cash Price |
$23.43
|
| Rate for Payer: Central Health Plan Commercial |
$41.66
|
| Rate for Payer: Cigna of CA HMO |
$33.32
|
| Rate for Payer: Cigna of CA PPO |
$38.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.83
|
| Rate for Payer: Galaxy Health WC |
$44.26
|
| Rate for Payer: Global Benefits Group Commercial |
$31.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.86
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$39.05
|
| Rate for Payer: IEHP medi-cal |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.05
|
| Rate for Payer: Networks By Design Commercial |
$33.85
|
| Rate for Payer: Prime Health Services Commercial |
$44.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31.24
|
| Rate for Payer: Riverside University Health MISP |
$20.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.04
|
| Rate for Payer: United Healthcare All Other HMO |
$26.04
|
| Rate for Payer: United Healthcare HMO Rider |
$26.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.26
|
| Rate for Payer: Vantage Medical Group Senior |
$44.26
|
|
|
HC TUBE TRACH NEO 3.5 UNCUFF
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901698413
|
|
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 NEO 3.5 UNCUFF
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901698413
|
|
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 NEONATAL 4.5
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901605117
|
|
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 NEONATAL 4.5
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901605117
|
|
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 PORTEX DIC
|
Facility
IP
|
$178.00
|
|
| Hospital Charge Code |
900800712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Central Health Plan Commercial |
$142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.60
|
| Rate for Payer: Multiplan Commercial |
$133.50
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
|
|
HC TUBE TRACH PORTEX DIC
|
Facility
OP
|
$178.00
|
|
| Hospital Charge Code |
900800712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$151.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$97.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$97.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$86.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.16
|
| Rate for Payer: BCBS Transplant Transplant |
$106.80
|
| Rate for Payer: Blue Shield of California Commercial |
$111.96
|
| Rate for Payer: Blue Shield of California EPN |
$87.04
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Central Health Plan Commercial |
$142.40
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$151.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$133.50
|
| Rate for Payer: IEHP medi-cal |
$62.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.60
|
| Rate for Payer: Multiplan Commercial |
$133.50
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: Riverside University Health MISP |
$71.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$89.00
|
| Rate for Payer: United Healthcare All Other HMO |
$89.00
|
| Rate for Payer: United Healthcare HMO Rider |
$89.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.30
|
| Rate for Payer: Vantage Medical Group Senior |
$151.30
|
|
|
HC TUBE TRACH SHILEY #10 CUFFLES
|
Facility
OP
|
$290.15
|
|
| Hospital Charge Code |
901603951
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$246.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$159.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.42
|
| Rate for Payer: BCBS Transplant Transplant |
$174.09
|
| Rate for Payer: Blue Shield of California Commercial |
$182.50
|
| Rate for Payer: Blue Shield of California EPN |
$141.88
|
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: Cigna of CA HMO |
$185.70
|
| Rate for Payer: Cigna of CA PPO |
$214.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$246.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$217.61
|
| Rate for Payer: IEHP medi-cal |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: Riverside University Health MISP |
$116.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.08
|
| Rate for Payer: United Healthcare All Other HMO |
$145.08
|
| Rate for Payer: United Healthcare HMO Rider |
$145.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$246.63
|
| Rate for Payer: Vantage Medical Group Senior |
$246.63
|
|
|
HC TUBE TRACH SHILEY #10 CUFFLES
|
Facility
IP
|
$290.15
|
|
| Hospital Charge Code |
901603951
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
|
|
HC TUBE TRACH SHILEY 10 UNCUFF
|
Facility
OP
|
$342.44
|
|
| Hospital Charge Code |
901698522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.49 |
| Max. Negotiated Rate |
$308.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$207.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$291.07
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$188.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$188.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.31
|
| Rate for Payer: BCBS Transplant Transplant |
$205.46
|
| Rate for Payer: Blue Shield of California Commercial |
$215.39
|
| Rate for Payer: Blue Shield of California EPN |
$167.45
|
| Rate for Payer: Cash Price |
$154.10
|
| Rate for Payer: Central Health Plan Commercial |
$273.95
|
| Rate for Payer: Cigna of CA HMO |
$219.16
|
| Rate for Payer: Cigna of CA PPO |
$253.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$291.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$136.98
|
| Rate for Payer: Galaxy Health WC |
$291.07
|
| Rate for Payer: Global Benefits Group Commercial |
$205.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$308.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$256.83
|
| Rate for Payer: IEHP medi-cal |
$119.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.49
|
| Rate for Payer: Multiplan Commercial |
$256.83
|
| Rate for Payer: Networks By Design Commercial |
$222.59
|
| Rate for Payer: Prime Health Services Commercial |
$291.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$205.46
|
| Rate for Payer: Riverside University Health MISP |
$136.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$171.22
|
| Rate for Payer: United Healthcare All Other HMO |
$171.22
|
| Rate for Payer: United Healthcare HMO Rider |
$171.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$171.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$291.07
|
| Rate for Payer: Vantage Medical Group Senior |
$291.07
|
|
|
HC TUBE TRACH SHILEY 10 UNCUFF
|
Facility
IP
|
$342.44
|
|
| Hospital Charge Code |
901698522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.49 |
| Max. Negotiated Rate |
$308.20 |
| Rate for Payer: Cash Price |
$154.10
|
| Rate for Payer: Central Health Plan Commercial |
$273.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.98
|
| Rate for Payer: Galaxy Health WC |
$291.07
|
| Rate for Payer: Global Benefits Group Commercial |
$205.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$308.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.49
|
| Rate for Payer: Multiplan Commercial |
$256.83
|
| Rate for Payer: Networks By Design Commercial |
$222.59
|
| Rate for Payer: Prime Health Services Commercial |
$291.07
|
|
|
HC TUBE TRACH SHILEY 4.0 NO CUFF
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901698492
|
|
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 SHILEY 4.0 NO CUFF
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901698492
|
|
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 SHILEY #4 CUFFLESS
|
Facility
OP
|
$290.15
|
|
| Hospital Charge Code |
901603948
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$246.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$159.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.42
|
| Rate for Payer: BCBS Transplant Transplant |
$174.09
|
| Rate for Payer: Blue Shield of California Commercial |
$182.50
|
| Rate for Payer: Blue Shield of California EPN |
$141.88
|
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: Cigna of CA HMO |
$185.70
|
| Rate for Payer: Cigna of CA PPO |
$214.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$246.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$217.61
|
| Rate for Payer: IEHP medi-cal |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: Riverside University Health MISP |
$116.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.08
|
| Rate for Payer: United Healthcare All Other HMO |
$145.08
|
| Rate for Payer: United Healthcare HMO Rider |
$145.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$246.63
|
| Rate for Payer: Vantage Medical Group Senior |
$246.63
|
|
|
HC TUBE TRACH SHILEY #4 CUFFLESS
|
Facility
IP
|
$290.15
|
|
| Hospital Charge Code |
901603948
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
|
|
HC TUBE TRACH SHILEY 6.4 CUFFLS
|
Facility
IP
|
$290.15
|
|
| Hospital Charge Code |
901603949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
|
|
HC TUBE TRACH SHILEY 6.4 CUFFLS
|
Facility
OP
|
$290.15
|
|
| Hospital Charge Code |
901603949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$261.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$246.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$159.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.42
|
| Rate for Payer: BCBS Transplant Transplant |
$174.09
|
| Rate for Payer: Blue Shield of California Commercial |
$182.50
|
| Rate for Payer: Blue Shield of California EPN |
$141.88
|
| Rate for Payer: Cash Price |
$130.57
|
| Rate for Payer: Central Health Plan Commercial |
$232.12
|
| Rate for Payer: Cigna of CA HMO |
$185.70
|
| Rate for Payer: Cigna of CA PPO |
$214.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$246.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.06
|
| Rate for Payer: Galaxy Health WC |
$246.63
|
| Rate for Payer: Global Benefits Group Commercial |
$174.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$217.61
|
| Rate for Payer: IEHP medi-cal |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.03
|
| Rate for Payer: Multiplan Commercial |
$217.61
|
| Rate for Payer: Networks By Design Commercial |
$188.60
|
| Rate for Payer: Prime Health Services Commercial |
$246.63
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: Riverside University Health MISP |
$116.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.08
|
| Rate for Payer: United Healthcare All Other HMO |
$145.08
|
| Rate for Payer: United Healthcare HMO Rider |
$145.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$246.63
|
| Rate for Payer: Vantage Medical Group Senior |
$246.63
|
|
|
HC TUBE TRACH SHILEY 6.5 UNCUFF
|
Facility
OP
|
$409.31
|
|
| Hospital Charge Code |
901698519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$368.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$248.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$347.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$225.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$225.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$198.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.82
|
| Rate for Payer: BCBS Transplant Transplant |
$245.59
|
| Rate for Payer: Blue Shield of California Commercial |
$257.46
|
| Rate for Payer: Blue Shield of California EPN |
$200.15
|
| Rate for Payer: Cash Price |
$184.19
|
| Rate for Payer: Central Health Plan Commercial |
$327.45
|
| Rate for Payer: Cigna of CA HMO |
$261.96
|
| Rate for Payer: Cigna of CA PPO |
$302.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$347.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.72
|
| Rate for Payer: Galaxy Health WC |
$347.91
|
| Rate for Payer: Global Benefits Group Commercial |
$245.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$368.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$306.98
|
| Rate for Payer: IEHP medi-cal |
$143.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.86
|
| Rate for Payer: Multiplan Commercial |
$306.98
|
| Rate for Payer: Networks By Design Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$347.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$245.59
|
| Rate for Payer: Riverside University Health MISP |
$163.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$245.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$245.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$204.66
|
| Rate for Payer: United Healthcare All Other HMO |
$204.66
|
| Rate for Payer: United Healthcare HMO Rider |
$204.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$204.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$347.91
|
| Rate for Payer: Vantage Medical Group Senior |
$347.91
|
|
|
HC TUBE TRACH SHILEY 6.5 UNCUFF
|
Facility
IP
|
$409.31
|
|
| Hospital Charge Code |
901698519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$368.38 |
| Rate for Payer: Cash Price |
$184.19
|
| Rate for Payer: Central Health Plan Commercial |
$327.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.72
|
| Rate for Payer: Galaxy Health WC |
$347.91
|
| Rate for Payer: Global Benefits Group Commercial |
$245.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$368.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.86
|
| Rate for Payer: Multiplan Commercial |
$306.98
|
| Rate for Payer: Networks By Design Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$347.91
|
|
|
HC TUBE TRACH SHILEY 7.5MM UNCUFF
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901698727
|
|
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 SHILEY 7.5MM UNCUFF
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901698727
|
|
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 SHILEY 7.5 UNCUFF
|
Facility
IP
|
$409.31
|
|
| Hospital Charge Code |
901698520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$368.38 |
| Rate for Payer: Cash Price |
$184.19
|
| Rate for Payer: Central Health Plan Commercial |
$327.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.72
|
| Rate for Payer: Galaxy Health WC |
$347.91
|
| Rate for Payer: Global Benefits Group Commercial |
$245.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$368.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.86
|
| Rate for Payer: Multiplan Commercial |
$306.98
|
| Rate for Payer: Networks By Design Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$347.91
|
|
|
HC TUBE TRACH SHILEY 7.5 UNCUFF
|
Facility
OP
|
$409.31
|
|
| Hospital Charge Code |
901698520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$368.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$248.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$347.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$225.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$225.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$198.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.82
|
| Rate for Payer: BCBS Transplant Transplant |
$245.59
|
| Rate for Payer: Blue Shield of California Commercial |
$257.46
|
| Rate for Payer: Blue Shield of California EPN |
$200.15
|
| Rate for Payer: Cash Price |
$184.19
|
| Rate for Payer: Central Health Plan Commercial |
$327.45
|
| Rate for Payer: Cigna of CA HMO |
$261.96
|
| Rate for Payer: Cigna of CA PPO |
$302.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$347.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.72
|
| Rate for Payer: Galaxy Health WC |
$347.91
|
| Rate for Payer: Global Benefits Group Commercial |
$245.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$368.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$306.98
|
| Rate for Payer: IEHP medi-cal |
$143.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.86
|
| Rate for Payer: Multiplan Commercial |
$306.98
|
| Rate for Payer: Networks By Design Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$347.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$245.59
|
| Rate for Payer: Riverside University Health MISP |
$163.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$245.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$245.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$204.66
|
| Rate for Payer: United Healthcare All Other HMO |
$204.66
|
| Rate for Payer: United Healthcare HMO Rider |
$204.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$204.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$347.91
|
| Rate for Payer: Vantage Medical Group Senior |
$347.91
|
|
|
HC TUBE TRACH SHILEY 7.6 CUFFLS
|
Facility
OP
|
$342.44
|
|
| Hospital Charge Code |
901603950
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.49 |
| Max. Negotiated Rate |
$308.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$207.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$291.07
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$188.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$188.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.31
|
| Rate for Payer: BCBS Transplant Transplant |
$205.46
|
| Rate for Payer: Blue Shield of California Commercial |
$215.39
|
| Rate for Payer: Blue Shield of California EPN |
$167.45
|
| Rate for Payer: Cash Price |
$154.10
|
| Rate for Payer: Central Health Plan Commercial |
$273.95
|
| Rate for Payer: Cigna of CA HMO |
$219.16
|
| Rate for Payer: Cigna of CA PPO |
$253.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$291.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$136.98
|
| Rate for Payer: Galaxy Health WC |
$291.07
|
| Rate for Payer: Global Benefits Group Commercial |
$205.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$308.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$256.83
|
| Rate for Payer: IEHP medi-cal |
$119.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.49
|
| Rate for Payer: Multiplan Commercial |
$256.83
|
| Rate for Payer: Networks By Design Commercial |
$222.59
|
| Rate for Payer: Prime Health Services Commercial |
$291.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$205.46
|
| Rate for Payer: Riverside University Health MISP |
$136.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$171.22
|
| Rate for Payer: United Healthcare All Other HMO |
$171.22
|
| Rate for Payer: United Healthcare HMO Rider |
$171.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$171.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$291.07
|
| Rate for Payer: Vantage Medical Group Senior |
$291.07
|
|
