|
HC BIOPTOME ARGON JAWZ
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906811728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC BIOPTOME ATC SPARROWHAWK
|
Facility
|
OP
|
$313.00
|
|
| Hospital Charge Code |
906812372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$190.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$266.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$172.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$234.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$182.07
|
| Rate for Payer: Blue Shield of California Commercial |
$198.44
|
| Rate for Payer: Blue Shield of California EPN |
$124.89
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$266.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$266.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$266.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$219.10
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Riverside University Health System MISP |
$125.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.50
|
| Rate for Payer: United Healthcare All Other HMO |
$156.50
|
| Rate for Payer: United Healthcare HMO Rider |
$156.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$266.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$266.05
|
| Rate for Payer: Vantage Medical Group Senior |
$266.05
|
|
|
HC BIOPTOME ATC SPARROWHAWK
|
Facility
|
IP
|
$313.00
|
|
| Hospital Charge Code |
906812372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC BIVONA ADULT AIRE-CUF 5.0
|
Facility
|
IP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$380.58 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Central Health Plan Commercial |
$338.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.57
|
| Rate for Payer: Multiplan Commercial |
$317.15
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 5.0
|
Facility
|
OP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$380.58 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.98
|
| Rate for Payer: Blue Shield of California Commercial |
$268.10
|
| Rate for Payer: Blue Shield of California EPN |
$168.73
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Central Health Plan Commercial |
$338.30
|
| Rate for Payer: Cigna of CA HMO |
$270.64
|
| Rate for Payer: Cigna of CA PPO |
$312.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$359.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$359.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$296.01
|
| Rate for Payer: Multiplan Commercial |
$317.15
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
| Rate for Payer: Riverside University Health System MISP |
$169.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.44
|
| Rate for Payer: United Healthcare All Other HMO |
$211.44
|
| Rate for Payer: United Healthcare HMO Rider |
$211.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$359.44
|
| Rate for Payer: Vantage Medical Group Senior |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 6.0
|
Facility
|
IP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$380.58 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Central Health Plan Commercial |
$338.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.57
|
| Rate for Payer: Multiplan Commercial |
$317.15
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 6.0
|
Facility
|
OP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$380.58 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.98
|
| Rate for Payer: Blue Shield of California Commercial |
$268.10
|
| Rate for Payer: Blue Shield of California EPN |
$168.73
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Central Health Plan Commercial |
$338.30
|
| Rate for Payer: Cigna of CA HMO |
$270.64
|
| Rate for Payer: Cigna of CA PPO |
$312.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$359.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$359.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$296.01
|
| Rate for Payer: Multiplan Commercial |
$317.15
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
| Rate for Payer: Riverside University Health System MISP |
$169.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.44
|
| Rate for Payer: United Healthcare All Other HMO |
$211.44
|
| Rate for Payer: United Healthcare HMO Rider |
$211.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$359.44
|
| Rate for Payer: Vantage Medical Group Senior |
$359.44
|
|
|
HC BIVONA CUSTOM TRACH TUBE
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$607.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$945.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$857.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$796.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
|
|
HC BIVONA CUSTOM TRACH TUBE
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$742.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,012.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$653.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$785.29
|
| Rate for Payer: Blue Shield of California Commercial |
$855.90
|
| Rate for Payer: Blue Shield of California EPN |
$538.65
|
| Rate for Payer: Cash Price |
$607.50
|
| Rate for Payer: Cash Price |
$607.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: Cigna of CA HMO |
$864.00
|
| Rate for Payer: Cigna of CA PPO |
$999.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,147.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,147.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$945.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$857.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$490.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$796.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$945.00
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
| Rate for Payer: Riverside University Health System MISP |
$540.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$810.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$675.00
|
| Rate for Payer: United Healthcare All Other HMO |
$675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$675.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$675.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,147.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,147.50
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 2.5
|
Facility
|
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$627.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.00
|
| Rate for Payer: Blue Shield of California Commercial |
$530.78
|
| Rate for Payer: Blue Shield of California EPN |
$334.04
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Cigna of CA HMO |
$535.81
|
| Rate for Payer: Cigna of CA PPO |
$619.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$711.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$711.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$303.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$586.04
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
| Rate for Payer: Riverside University Health System MISP |
$334.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$418.60
|
| Rate for Payer: United Healthcare All Other HMO |
$418.60
|
| Rate for Payer: United Healthcare HMO Rider |
$418.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 2.5
|
Facility
|
IP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 3.0
|
Facility
|
IP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 3.0
|
Facility
|
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$627.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.00
|
| Rate for Payer: Blue Shield of California Commercial |
$530.78
|
| Rate for Payer: Blue Shield of California EPN |
$334.04
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Cigna of CA HMO |
$535.81
|
| Rate for Payer: Cigna of CA PPO |
$619.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$711.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$711.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$303.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$586.04
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
| Rate for Payer: Riverside University Health System MISP |
$334.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$418.60
|
| Rate for Payer: United Healthcare All Other HMO |
$418.60
|
| Rate for Payer: United Healthcare HMO Rider |
$418.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 3.5
|
Facility
|
OP
|
$830.76
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$747.68 |
| Rate for Payer: Adventist Health Commercial |
$166.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$706.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$623.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$402.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$483.25
|
| Rate for Payer: Blue Shield of California Commercial |
$526.70
|
| Rate for Payer: Blue Shield of California EPN |
$331.47
|
| Rate for Payer: Cash Price |
$373.84
|
| Rate for Payer: Cash Price |
$373.84
|
| Rate for Payer: Central Health Plan Commercial |
$664.61
|
| Rate for Payer: Cigna of CA HMO |
$531.69
|
| Rate for Payer: Cigna of CA PPO |
$614.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$706.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$706.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$706.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.30
|
| Rate for Payer: EPIC Health Plan Senior |
$332.30
|
| Rate for Payer: Galaxy Health WC |
$706.15
|
| Rate for Payer: Global Benefits Group Commercial |
$498.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$301.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$581.53
|
| Rate for Payer: Multiplan Commercial |
$623.07
|
| Rate for Payer: Networks By Design Commercial |
$539.99
|
| Rate for Payer: Prime Health Services Commercial |
$706.15
|
| Rate for Payer: Riverside University Health System MISP |
$332.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$415.38
|
| Rate for Payer: United Healthcare All Other HMO |
$415.38
|
| Rate for Payer: United Healthcare HMO Rider |
$415.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$415.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$706.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$706.15
|
| Rate for Payer: Vantage Medical Group Senior |
$706.15
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 3.5
|
Facility
|
IP
|
$830.76
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.15 |
| Max. Negotiated Rate |
$747.68 |
| Rate for Payer: Adventist Health Commercial |
$166.15
|
| Rate for Payer: Cash Price |
$373.84
|
| Rate for Payer: Central Health Plan Commercial |
$664.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.30
|
| Rate for Payer: EPIC Health Plan Senior |
$332.30
|
| Rate for Payer: Galaxy Health WC |
$706.15
|
| Rate for Payer: Global Benefits Group Commercial |
$498.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.15
|
| Rate for Payer: Multiplan Commercial |
$623.07
|
| Rate for Payer: Networks By Design Commercial |
$539.99
|
| Rate for Payer: Prime Health Services Commercial |
$706.15
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 4.0
|
Facility
|
OP
|
$844.42
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$759.98 |
| Rate for Payer: Adventist Health Commercial |
$168.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$717.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$464.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$633.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$491.20
|
| Rate for Payer: Blue Shield of California Commercial |
$535.36
|
| Rate for Payer: Blue Shield of California EPN |
$336.92
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: Cigna of CA HMO |
$540.43
|
| Rate for Payer: Cigna of CA PPO |
$624.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$717.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$717.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$717.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$591.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.77
|
| Rate for Payer: EPIC Health Plan Senior |
$337.77
|
| Rate for Payer: Galaxy Health WC |
$717.76
|
| Rate for Payer: Global Benefits Group Commercial |
$506.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$536.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$498.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$591.09
|
| Rate for Payer: Multiplan Commercial |
$633.32
|
| Rate for Payer: Networks By Design Commercial |
$548.87
|
| Rate for Payer: Prime Health Services Commercial |
$717.76
|
| Rate for Payer: Riverside University Health System MISP |
$337.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.21
|
| Rate for Payer: United Healthcare All Other HMO |
$422.21
|
| Rate for Payer: United Healthcare HMO Rider |
$422.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$422.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$717.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$717.76
|
| Rate for Payer: Vantage Medical Group Senior |
$717.76
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 4.0
|
Facility
|
IP
|
$844.42
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.88 |
| Max. Negotiated Rate |
$759.98 |
| Rate for Payer: Adventist Health Commercial |
$168.88
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$591.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.77
|
| Rate for Payer: EPIC Health Plan Senior |
$337.77
|
| Rate for Payer: Galaxy Health WC |
$717.76
|
| Rate for Payer: Global Benefits Group Commercial |
$506.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$536.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$498.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.88
|
| Rate for Payer: Multiplan Commercial |
$633.32
|
| Rate for Payer: Networks By Design Commercial |
$548.87
|
| Rate for Payer: Prime Health Services Commercial |
$717.76
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 4.5
|
Facility
|
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$627.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.00
|
| Rate for Payer: Blue Shield of California Commercial |
$530.78
|
| Rate for Payer: Blue Shield of California EPN |
$334.04
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Cigna of CA HMO |
$535.81
|
| Rate for Payer: Cigna of CA PPO |
$619.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$711.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$711.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$303.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$586.04
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
| Rate for Payer: Riverside University Health System MISP |
$334.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$418.60
|
| Rate for Payer: United Healthcare All Other HMO |
$418.60
|
| Rate for Payer: United Healthcare HMO Rider |
$418.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 4.5
|
Facility
|
IP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 5.0
|
Facility
|
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$627.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.00
|
| Rate for Payer: Blue Shield of California Commercial |
$530.78
|
| Rate for Payer: Blue Shield of California EPN |
$334.04
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Cigna of CA HMO |
$535.81
|
| Rate for Payer: Cigna of CA PPO |
$619.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$711.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$711.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$303.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$586.04
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
| Rate for Payer: Riverside University Health System MISP |
$334.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$418.60
|
| Rate for Payer: United Healthcare All Other HMO |
$418.60
|
| Rate for Payer: United Healthcare HMO Rider |
$418.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 5.0
|
Facility
|
IP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$586.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$531.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$493.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.44
|
| Rate for Payer: Multiplan Commercial |
$627.90
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 5.5
|
Facility
|
IP
|
$844.42
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.88 |
| Max. Negotiated Rate |
$759.98 |
| Rate for Payer: Adventist Health Commercial |
$168.88
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$591.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.77
|
| Rate for Payer: EPIC Health Plan Senior |
$337.77
|
| Rate for Payer: Galaxy Health WC |
$717.76
|
| Rate for Payer: Global Benefits Group Commercial |
$506.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$536.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$498.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.88
|
| Rate for Payer: Multiplan Commercial |
$633.32
|
| Rate for Payer: Networks By Design Commercial |
$548.87
|
| Rate for Payer: Prime Health Services Commercial |
$717.76
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 5.5
|
Facility
|
OP
|
$844.42
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$759.98 |
| Rate for Payer: Adventist Health Commercial |
$168.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$717.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$464.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$633.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$491.20
|
| Rate for Payer: Blue Shield of California Commercial |
$535.36
|
| Rate for Payer: Blue Shield of California EPN |
$336.92
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: Cigna of CA HMO |
$540.43
|
| Rate for Payer: Cigna of CA PPO |
$624.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$717.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$717.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$717.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$591.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.77
|
| Rate for Payer: EPIC Health Plan Senior |
$337.77
|
| Rate for Payer: Galaxy Health WC |
$717.76
|
| Rate for Payer: Global Benefits Group Commercial |
$506.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$536.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$498.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$591.09
|
| Rate for Payer: Multiplan Commercial |
$633.32
|
| Rate for Payer: Networks By Design Commercial |
$548.87
|
| Rate for Payer: Prime Health Services Commercial |
$717.76
|
| Rate for Payer: Riverside University Health System MISP |
$337.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.21
|
| Rate for Payer: United Healthcare All Other HMO |
$422.21
|
| Rate for Payer: United Healthcare HMO Rider |
$422.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$422.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$717.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$717.76
|
| Rate for Payer: Vantage Medical Group Senior |
$717.76
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 6.0
|
Facility
|
IP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.74 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Adventist Health Commercial |
$169.74
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Senior |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.39
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$538.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$500.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.74
|
| Rate for Payer: Multiplan Commercial |
$636.52
|
| Rate for Payer: Networks By Design Commercial |
$551.65
|
| Rate for Payer: Prime Health Services Commercial |
$721.39
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 6.0
|
Facility
|
OP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Adventist Health Commercial |
$169.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$721.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$466.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$493.69
|
| Rate for Payer: Blue Shield of California Commercial |
$538.08
|
| Rate for Payer: Blue Shield of California EPN |
$338.63
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: Cigna of CA HMO |
$543.17
|
| Rate for Payer: Cigna of CA PPO |
$628.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$721.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$721.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$721.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Senior |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.39
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$538.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$308.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$500.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$594.09
|
| Rate for Payer: Multiplan Commercial |
$636.52
|
| Rate for Payer: Networks By Design Commercial |
$551.65
|
| Rate for Payer: Prime Health Services Commercial |
$721.39
|
| Rate for Payer: Riverside University Health System MISP |
$339.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$509.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$509.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$424.35
|
| Rate for Payer: United Healthcare All Other HMO |
$424.35
|
| Rate for Payer: United Healthcare HMO Rider |
$424.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$424.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$721.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$721.39
|
| Rate for Payer: Vantage Medical Group Senior |
$721.39
|
|
