|
HC AIRWAY, GUEDEL 90MM, YELLOW
|
Facility
|
IP
|
$2.46
|
|
| Hospital Charge Code |
901608004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Adventist Health Commercial |
$0.49
|
| Rate for Payer: Cash Price |
$1.35
|
| Rate for Payer: Central Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.98
|
| Rate for Payer: EPIC Health Plan Senior |
$0.98
|
| Rate for Payer: Galaxy Health WC |
$2.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.49
|
| Rate for Payer: Multiplan Commercial |
$1.84
|
| Rate for Payer: Networks By Design Commercial |
$1.60
|
| Rate for Payer: Prime Health Services Commercial |
$2.09
|
|
|
HC AIRWAY GUEDEL SIZE 1 60MM
|
Facility
|
OP
|
$6.89
|
|
| Hospital Charge Code |
901698637
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Adventist Health Commercial |
$1.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.05
|
| Rate for Payer: Blue Shield of California Commercial |
$4.21
|
| Rate for Payer: Blue Shield of California EPN |
$2.75
|
| Rate for Payer: Cash Price |
$3.79
|
| Rate for Payer: Central Health Plan Commercial |
$5.51
|
| Rate for Payer: Cigna of CA HMO |
$4.41
|
| Rate for Payer: Cigna of CA PPO |
$5.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: EPIC Health Plan Senior |
$2.76
|
| Rate for Payer: Galaxy Health WC |
$5.86
|
| Rate for Payer: Global Benefits Group Commercial |
$4.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.20
|
| Rate for Payer: InnovAge PACE Commercial |
$3.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.82
|
| Rate for Payer: Multiplan Commercial |
$5.17
|
| Rate for Payer: Networks By Design Commercial |
$4.48
|
| Rate for Payer: Prime Health Services Commercial |
$5.86
|
| Rate for Payer: Riverside University Health System MISP |
$2.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.44
|
| Rate for Payer: United Healthcare All Other HMO |
$3.44
|
| Rate for Payer: United Healthcare HMO Rider |
$3.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.86
|
| Rate for Payer: Vantage Medical Group Senior |
$5.86
|
|
|
HC AIRWAY GUEDEL SIZE 1 60MM
|
Facility
|
IP
|
$6.89
|
|
| Hospital Charge Code |
901698637
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Adventist Health Commercial |
$1.38
|
| Rate for Payer: Cash Price |
$3.79
|
| Rate for Payer: Central Health Plan Commercial |
$5.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: EPIC Health Plan Senior |
$2.76
|
| Rate for Payer: Galaxy Health WC |
$5.86
|
| Rate for Payer: Global Benefits Group Commercial |
$4.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$5.17
|
| Rate for Payer: Networks By Design Commercial |
$4.48
|
| Rate for Payer: Prime Health Services Commercial |
$5.86
|
|
|
HC AIRWAY GUEDEL SIZE 1 60MM 6CM
|
Facility
|
OP
|
$6.97
|
|
| Hospital Charge Code |
901698638
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.09
|
| Rate for Payer: Blue Shield of California Commercial |
$4.26
|
| Rate for Payer: Blue Shield of California EPN |
$2.78
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: InnovAge PACE Commercial |
$3.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC AIRWAY GUEDEL SIZE 1 60MM 6CM
|
Facility
|
IP
|
$6.97
|
|
| Hospital Charge Code |
901698638
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
|
|
HC AIRWAY GUEDEL SZ6 110MM ORG XL
|
Facility
|
OP
|
$4.59
|
|
| Hospital Charge Code |
901698838
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Adventist Health Commercial |
$0.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.70
|
| Rate for Payer: Blue Shield of California Commercial |
$2.80
|
| Rate for Payer: Blue Shield of California EPN |
$1.83
|
| Rate for Payer: Cash Price |
$2.52
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$3.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Senior |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: InnovAge PACE Commercial |
$2.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.21
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
| Rate for Payer: Riverside University Health System MISP |
$1.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.29
|
| Rate for Payer: United Healthcare All Other HMO |
$2.29
|
| Rate for Payer: United Healthcare HMO Rider |
$2.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3.90
|
|
|
HC AIRWAY GUEDEL SZ6 110MM ORG XL
|
Facility
|
IP
|
$4.59
|
|
| Hospital Charge Code |
901698838
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Adventist Health Commercial |
$0.92
|
| Rate for Payer: Cash Price |
$2.52
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Senior |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
|
|
HC AIRWAY LMA UNIQUE CUFF 2
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY LMA UNIQUE CUFF 2
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY LMA UNIQUE CUFF 2.5
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY LMA UNIQUE CUFF 2.5
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY LMA UNIQUE SIZE 1.5
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698335
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY LMA UNIQUE SIZE 1.5
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698335
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #3
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698541
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #3
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698541
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #4
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698542
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #4
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698542
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #5
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698543
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC AIRWAY MASK LMA CUFF PILOT #5
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698543
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC AIRWAY NASAL ARGYLE 26FR
|
Facility
|
OP
|
$35.92
|
|
| Hospital Charge Code |
901698905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.10
|
| Rate for Payer: Blue Shield of California Commercial |
$21.95
|
| Rate for Payer: Blue Shield of California EPN |
$14.33
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$22.99
|
| Rate for Payer: Cigna of CA PPO |
$26.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: InnovAge PACE Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.14
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
| Rate for Payer: Riverside University Health System MISP |
$14.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.53
|
| Rate for Payer: Vantage Medical Group Senior |
$30.53
|
|
|
HC AIRWAY NASAL ARGYLE 26FR
|
Facility
|
IP
|
$35.92
|
|
| Hospital Charge Code |
901698905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
|
|
HC AIRWAY NASAL ARGYLE 28FR
|
Facility
|
IP
|
$35.92
|
|
| Hospital Charge Code |
901698906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
|
|
HC AIRWAY NASAL ARGYLE 28FR
|
Facility
|
OP
|
$35.92
|
|
| Hospital Charge Code |
901698906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.10
|
| Rate for Payer: Blue Shield of California Commercial |
$21.95
|
| Rate for Payer: Blue Shield of California EPN |
$14.33
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$22.99
|
| Rate for Payer: Cigna of CA PPO |
$26.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: InnovAge PACE Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.14
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
| Rate for Payer: Riverside University Health System MISP |
$14.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.53
|
| Rate for Payer: Vantage Medical Group Senior |
$30.53
|
|
|
HC AIRWAY NASAL ARGYLE 30FR
|
Facility
|
OP
|
$35.92
|
|
| Hospital Charge Code |
901698907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.10
|
| Rate for Payer: Blue Shield of California Commercial |
$21.95
|
| Rate for Payer: Blue Shield of California EPN |
$14.33
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$22.99
|
| Rate for Payer: Cigna of CA PPO |
$26.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: InnovAge PACE Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.14
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
| Rate for Payer: Riverside University Health System MISP |
$14.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.53
|
| Rate for Payer: Vantage Medical Group Senior |
$30.53
|
|
|
HC AIRWAY NASAL ARGYLE 30FR
|
Facility
|
IP
|
$35.92
|
|
| Hospital Charge Code |
901698907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
|
