|
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: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$563.23
|
| 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
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: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$558.41
|
| 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 4.5
|
Facility
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$460.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$494.62
|
| Rate for Payer: BCBS Transplant Transplant |
$502.32
|
| Rate for Payer: Blue Shield of California Commercial |
$526.60
|
| Rate for Payer: Blue Shield of California EPN |
$409.39
|
| 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: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$627.90
|
| Rate for Payer: IEHP medi-cal |
$293.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$558.41
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: Riverside University Health 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 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: Cash Price |
$376.74
|
| Rate for Payer: Central Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$558.41
|
| 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 |
$124.68 |
| Max. Negotiated Rate |
$753.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$460.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$494.62
|
| Rate for Payer: BCBS Transplant Transplant |
$502.32
|
| Rate for Payer: Blue Shield of California Commercial |
$526.60
|
| Rate for Payer: Blue Shield of California EPN |
$409.39
|
| 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: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$627.90
|
| Rate for Payer: IEHP medi-cal |
$293.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$558.41
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
|
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 |
$124.68 |
| Max. Negotiated Rate |
$759.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$717.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$464.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$464.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$498.88
|
| Rate for Payer: BCBS Transplant Transplant |
$506.65
|
| Rate for Payer: Blue Shield of California Commercial |
$531.14
|
| Rate for Payer: Blue Shield of California EPN |
$412.92
|
| 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: EPIC Health Plan Commercial |
$337.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$633.32
|
| Rate for Payer: IEHP medi-cal |
$295.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$563.23
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$506.65
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$717.76
|
| Rate for Payer: Vantage Medical Group Senior |
$717.76
|
|
|
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: Cash Price |
$379.99
|
| Rate for Payer: Central Health Plan Commercial |
$675.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$563.23
|
| 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 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: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
|
|
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 |
$124.68 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$721.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$466.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$466.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.41
|
| Rate for Payer: BCBS Transplant Transplant |
$509.22
|
| Rate for Payer: Blue Shield of California Commercial |
$533.83
|
| Rate for Payer: Blue Shield of California EPN |
$415.01
|
| 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 |
$721.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$636.52
|
| Rate for Payer: IEHP medi-cal |
$297.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$509.22
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$721.40
|
| Rate for Payer: Vantage Medical Group Senior |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 7.0
|
Facility
IP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.74 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 7.0
|
Facility
OP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$721.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$466.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$466.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.41
|
| Rate for Payer: BCBS Transplant Transplant |
$509.22
|
| Rate for Payer: Blue Shield of California Commercial |
$533.83
|
| Rate for Payer: Blue Shield of California EPN |
$415.01
|
| 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 |
$721.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$636.52
|
| Rate for Payer: IEHP medi-cal |
$297.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$509.22
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$721.40
|
| Rate for Payer: Vantage Medical Group Senior |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 8.0
|
Facility
OP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$721.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$466.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$466.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.41
|
| Rate for Payer: BCBS Transplant Transplant |
$509.22
|
| Rate for Payer: Blue Shield of California Commercial |
$533.83
|
| Rate for Payer: Blue Shield of California EPN |
$415.01
|
| 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 |
$721.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$636.52
|
| Rate for Payer: IEHP medi-cal |
$297.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$509.22
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$721.40
|
| Rate for Payer: Vantage Medical Group Senior |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 8.0
|
Facility
IP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.74 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 9.0
|
Facility
OP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$721.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$466.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$466.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.41
|
| Rate for Payer: BCBS Transplant Transplant |
$509.22
|
| Rate for Payer: Blue Shield of California Commercial |
$533.83
|
| Rate for Payer: Blue Shield of California EPN |
$415.01
|
| 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 |
$721.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$636.52
|
| Rate for Payer: IEHP medi-cal |
$297.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$509.22
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$721.40
|
| Rate for Payer: Vantage Medical Group Senior |
$721.40
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 9.0
|
Facility
IP
|
$848.70
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.74 |
| Max. Negotiated Rate |
$763.83 |
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Central Health Plan Commercial |
$678.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.48
|
| Rate for Payer: Galaxy Health WC |
$721.40
|
| Rate for Payer: Global Benefits Group Commercial |
$509.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$763.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.08
|
| 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 |
$551.66
|
| Rate for Payer: Prime Health Services Commercial |
$721.40
|
|
|
HC BIVONA HYPERFLEX TUBE
|
Facility
OP
|
$738.00
|
|
| Hospital Charge Code |
900800702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$448.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$627.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$405.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$405.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$357.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$436.01
|
| Rate for Payer: BCBS Transplant Transplant |
$442.80
|
| Rate for Payer: Blue Shield of California Commercial |
$464.20
|
| Rate for Payer: Blue Shield of California EPN |
$360.88
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: Cigna of CA HMO |
$472.32
|
| Rate for Payer: Cigna of CA PPO |
$546.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$627.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$295.20
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$553.50
|
| Rate for Payer: IEHP medi-cal |
$258.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$492.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$442.80
|
| Rate for Payer: Riverside University Health MISP |
$295.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$442.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$442.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$369.00
|
| Rate for Payer: United Healthcare All Other HMO |
$369.00
|
| Rate for Payer: United Healthcare HMO Rider |
$369.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$627.30
|
| Rate for Payer: Vantage Medical Group Senior |
$627.30
|
|
|
HC BIVONA HYPERFLEX TUBE
|
Facility
IP
|
$738.00
|
|
| Hospital Charge Code |
900800702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.20
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$492.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
|
|
HC BIVONA NEO FLEX TEND PLUS 2.5
|
Facility
OP
|
$758.08
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$682.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$644.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$416.94
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$416.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$367.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.87
|
| Rate for Payer: BCBS Transplant Transplant |
$454.85
|
| Rate for Payer: Blue Shield of California Commercial |
$476.83
|
| Rate for Payer: Blue Shield of California EPN |
$370.70
|
| Rate for Payer: Cash Price |
$341.14
|
| Rate for Payer: Cash Price |
$341.14
|
| Rate for Payer: Central Health Plan Commercial |
$606.46
|
| Rate for Payer: Cigna of CA HMO |
$485.17
|
| Rate for Payer: Cigna of CA PPO |
$560.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$644.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$303.23
|
| Rate for Payer: Galaxy Health WC |
$644.37
|
| Rate for Payer: Global Benefits Group Commercial |
$454.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$682.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$568.56
|
| Rate for Payer: IEHP medi-cal |
$265.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$505.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.62
|
| Rate for Payer: Multiplan Commercial |
$568.56
|
| Rate for Payer: Networks By Design Commercial |
$492.75
|
| Rate for Payer: Prime Health Services Commercial |
$644.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$454.85
|
| Rate for Payer: Riverside University Health MISP |
$303.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$454.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$454.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$379.04
|
| Rate for Payer: United Healthcare All Other HMO |
$379.04
|
| Rate for Payer: United Healthcare HMO Rider |
$379.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$379.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$644.37
|
| Rate for Payer: Vantage Medical Group Senior |
$644.37
|
|
|
HC BIVONA NEO FLEX TEND PLUS 2.5
|
Facility
IP
|
$758.08
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$151.62 |
| Max. Negotiated Rate |
$682.27 |
| Rate for Payer: Cash Price |
$341.14
|
| Rate for Payer: Central Health Plan Commercial |
$606.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.23
|
| Rate for Payer: Galaxy Health WC |
$644.37
|
| Rate for Payer: Global Benefits Group Commercial |
$454.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$682.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$505.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.62
|
| Rate for Payer: Multiplan Commercial |
$568.56
|
| Rate for Payer: Networks By Design Commercial |
$492.75
|
| Rate for Payer: Prime Health Services Commercial |
$644.37
|
|
|
HC BIVONA NEO FLEX TEND PLUS 3.0
|
Facility
IP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800798
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.96 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
|
|
HC BIVONA NEO FLEX TEND PLUS 3.0
|
Facility
OP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800798
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$603.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$390.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$390.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$343.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.34
|
| Rate for Payer: BCBS Transplant Transplant |
$425.87
|
| Rate for Payer: Blue Shield of California Commercial |
$446.45
|
| Rate for Payer: Blue Shield of California EPN |
$347.08
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: Cigna of CA HMO |
$454.26
|
| Rate for Payer: Cigna of CA PPO |
$525.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$603.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$532.34
|
| Rate for Payer: IEHP medi-cal |
$248.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: Riverside University Health MISP |
$283.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$425.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$354.89
|
| Rate for Payer: United Healthcare All Other HMO |
$354.89
|
| Rate for Payer: United Healthcare HMO Rider |
$354.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$354.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$603.31
|
| Rate for Payer: Vantage Medical Group Senior |
$603.31
|
|
|
HC BIVONA NEO FLEX TEND PLUS 3.5
|
Facility
IP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800799
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.96 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
|
|
HC BIVONA NEO FLEX TEND PLUS 3.5
|
Facility
OP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800799
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$603.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$390.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$390.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$343.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.34
|
| Rate for Payer: BCBS Transplant Transplant |
$425.87
|
| Rate for Payer: Blue Shield of California Commercial |
$446.45
|
| Rate for Payer: Blue Shield of California EPN |
$347.08
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: Cigna of CA HMO |
$454.26
|
| Rate for Payer: Cigna of CA PPO |
$525.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$603.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$532.34
|
| Rate for Payer: IEHP medi-cal |
$248.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: Riverside University Health MISP |
$283.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$425.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$354.89
|
| Rate for Payer: United Healthcare All Other HMO |
$354.89
|
| Rate for Payer: United Healthcare HMO Rider |
$354.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$354.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$603.31
|
| Rate for Payer: Vantage Medical Group Senior |
$603.31
|
|
|
HC BIVONA NEO FLEX TEND PLUS 4.0
|
Facility
IP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.96 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
|
|
HC BIVONA NEO FLEX TEND PLUS 4.0
|
Facility
OP
|
$709.78
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$638.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$603.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$390.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$390.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$343.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.34
|
| Rate for Payer: BCBS Transplant Transplant |
$425.87
|
| Rate for Payer: Blue Shield of California Commercial |
$446.45
|
| Rate for Payer: Blue Shield of California EPN |
$347.08
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Cash Price |
$319.40
|
| Rate for Payer: Central Health Plan Commercial |
$567.82
|
| Rate for Payer: Cigna of CA HMO |
$454.26
|
| Rate for Payer: Cigna of CA PPO |
$525.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$603.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$283.91
|
| Rate for Payer: Galaxy Health WC |
$603.31
|
| Rate for Payer: Global Benefits Group Commercial |
$425.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$638.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$532.34
|
| Rate for Payer: IEHP medi-cal |
$248.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$473.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.96
|
| Rate for Payer: Multiplan Commercial |
$532.34
|
| Rate for Payer: Networks By Design Commercial |
$461.36
|
| Rate for Payer: Prime Health Services Commercial |
$603.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: Riverside University Health MISP |
$283.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$425.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$425.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$354.89
|
| Rate for Payer: United Healthcare All Other HMO |
$354.89
|
| Rate for Payer: United Healthcare HMO Rider |
$354.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$354.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$603.31
|
| Rate for Payer: Vantage Medical Group Senior |
$603.31
|
|
