|
HC TELETHERAPY ISODOSE PLANSIMPLE
|
Facility
|
OP
|
$1,051.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
909177306
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$210.20 |
| Max. Negotiated Rate |
$1,759.00 |
| Rate for Payer: Adventist Health Commercial |
$210.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$689.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$718.57
|
| Rate for Payer: Blue Shield of California Commercial |
$643.21
|
| Rate for Payer: Blue Shield of California EPN |
$424.60
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cigna of CA HMO |
$672.64
|
| Rate for Payer: Cigna of CA PPO |
$777.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$697.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$511.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$465.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.93
|
| Rate for Payer: EPIC Health Plan Senior |
$465.13
|
| Rate for Payer: Galaxy Health WC |
$893.35
|
| Rate for Payer: Global Benefits Group Commercial |
$630.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$762.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$216.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$465.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$701.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$586.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.27
|
| Rate for Payer: Multiplan Commercial |
$840.80
|
| Rate for Payer: Networks By Design Commercial |
$683.15
|
| Rate for Payer: Prime Health Services Commercial |
$893.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$630.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$465.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Vantage Medical Group Senior |
$465.13
|
|
|
HC TELETHERAPY ISODOSE PLANSIMPLE
|
Facility
|
IP
|
$1,051.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
909177306
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$210.20 |
| Max. Negotiated Rate |
$893.35 |
| Rate for Payer: Adventist Health Commercial |
$210.20
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$420.40
|
| Rate for Payer: EPIC Health Plan Senior |
$420.40
|
| Rate for Payer: Galaxy Health WC |
$893.35
|
| Rate for Payer: Global Benefits Group Commercial |
$630.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$701.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$650.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.24
|
| Rate for Payer: Multiplan Commercial |
$840.80
|
| Rate for Payer: Networks By Design Commercial |
$683.15
|
| Rate for Payer: Prime Health Services Commercial |
$893.35
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
IP
|
$3,630.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$726.00 |
| Max. Negotiated Rate |
$3,085.50 |
| Rate for Payer: Adventist Health Commercial |
$726.00
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,452.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,452.00
|
| Rate for Payer: Galaxy Health WC |
$3,085.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,178.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,421.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,383.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,246.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.20
|
| Rate for Payer: Multiplan Commercial |
$2,904.00
|
| Rate for Payer: Networks By Design Commercial |
$2,359.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,085.50
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
OP
|
$3,630.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.37 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$726.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,230.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cigna of CA HMO |
$2,323.20
|
| Rate for Payer: Cigna of CA PPO |
$2,686.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,353.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,230.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,661.35
|
| Rate for Payer: EPIC Health Plan Senior |
$1,230.63
|
| Rate for Payer: Galaxy Health WC |
$3,085.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,178.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,018.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,230.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,421.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,230.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,550.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,649.04
|
| Rate for Payer: Multiplan Commercial |
$2,904.00
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,359.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,085.50
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,178.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,815.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,815.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,815.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,815.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,230.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,230.63
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$15,065.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,013.00 |
| Max. Negotiated Rate |
$12,805.25 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,026.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,026.00
|
| Rate for Payer: Galaxy Health WC |
$12,805.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,039.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,048.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,739.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,325.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Multiplan Commercial |
$12,052.00
|
| Rate for Payer: Networks By Design Commercial |
$9,792.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,805.25
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$15,065.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$294.59 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cigna of CA HMO |
$9,792.25
|
| Rate for Payer: Cigna of CA PPO |
$11,148.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,805.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,039.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$294.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,048.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$12,052.00
|
| Rate for Payer: Networks By Design Commercial |
$9,792.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,805.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,039.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,039.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$15,065.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$333.17 |
| Max. Negotiated Rate |
$17,245.35 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: Cigna of CA HMO |
$9,641.60
|
| Rate for Payer: Cigna of CA PPO |
$11,148.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,805.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,039.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,048.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$12,052.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,792.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,805.25
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,039.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,532.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,532.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,532.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,532.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$15,065.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,013.00 |
| Max. Negotiated Rate |
$12,805.25 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Cash Price |
$8,285.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,026.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,026.00
|
| Rate for Payer: Galaxy Health WC |
$12,805.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,039.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,048.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,739.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,325.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Multiplan Commercial |
$12,052.00
|
| Rate for Payer: Networks By Design Commercial |
$9,792.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,805.25
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$14,641.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906820054
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$294.59 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,928.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Cigna of CA HMO |
$9,516.65
|
| Rate for Payer: Cigna of CA PPO |
$10,834.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,444.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,784.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$294.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,513.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$11,712.80
|
| Rate for Payer: Networks By Design Commercial |
$9,516.65
|
| Rate for Payer: Prime Health Services Commercial |
$12,444.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,784.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,784.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$14,641.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906820054
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,928.20 |
| Max. Negotiated Rate |
$12,444.85 |
| Rate for Payer: Adventist Health Commercial |
$2,928.20
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,856.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,856.40
|
| Rate for Payer: Galaxy Health WC |
$12,444.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,784.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,578.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,062.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,513.84
|
| Rate for Payer: Multiplan Commercial |
$11,712.80
|
| Rate for Payer: Networks By Design Commercial |
$9,516.65
|
| Rate for Payer: Prime Health Services Commercial |
$12,444.85
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$13,944.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906820103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,788.80 |
| Max. Negotiated Rate |
$11,852.40 |
| Rate for Payer: Adventist Health Commercial |
$2,788.80
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,577.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,577.60
|
| Rate for Payer: Galaxy Health WC |
$11,852.40
|
| Rate for Payer: Global Benefits Group Commercial |
$8,366.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,300.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,312.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,631.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.56
|
| Rate for Payer: Multiplan Commercial |
$11,155.20
|
| Rate for Payer: Networks By Design Commercial |
$9,063.60
|
| Rate for Payer: Prime Health Services Commercial |
$11,852.40
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$14,347.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,869.40 |
| Max. Negotiated Rate |
$12,194.95 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,738.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,738.80
|
| Rate for Payer: Galaxy Health WC |
$12,194.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,608.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,569.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,466.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,880.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Multiplan Commercial |
$11,477.60
|
| Rate for Payer: Networks By Design Commercial |
$9,325.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,194.95
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$14,347.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,869.40 |
| Max. Negotiated Rate |
$12,194.95 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,738.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,738.80
|
| Rate for Payer: Galaxy Health WC |
$12,194.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,608.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,569.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,466.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,880.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Multiplan Commercial |
$11,477.60
|
| Rate for Payer: Networks By Design Commercial |
$9,325.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,194.95
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$14,347.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$495.16 |
| Max. Negotiated Rate |
$17,245.35 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cigna of CA HMO |
$9,182.08
|
| Rate for Payer: Cigna of CA PPO |
$10,616.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,194.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,608.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,569.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$11,477.60
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,325.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,194.95
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,608.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,173.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,173.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,173.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,173.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$13,944.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906820103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,788.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Cigna of CA HMO |
$8,924.16
|
| Rate for Payer: Cigna of CA PPO |
$10,318.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$11,852.40
|
| Rate for Payer: Global Benefits Group Commercial |
$8,366.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$437.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,300.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$11,155.20
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,063.60
|
| Rate for Payer: Prime Health Services Commercial |
$11,852.40
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,366.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$14,347.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cash Price |
$7,890.85
|
| Rate for Payer: Cigna of CA HMO |
$9,182.08
|
| Rate for Payer: Cigna of CA PPO |
$10,616.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,194.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,608.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$437.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,569.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$11,477.60
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,325.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,194.95
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,608.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$3,002.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$600.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,651.10
|
| Rate for Payer: Cash Price |
$1,651.10
|
| Rate for Payer: Cash Price |
$1,651.10
|
| Rate for Payer: Cigna of CA HMO |
$1,921.28
|
| Rate for Payer: Cigna of CA PPO |
$2,221.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$2,551.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,801.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,002.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,047.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$2,401.60
|
| Rate for Payer: Multiplan WC |
$1,324.78
|
| Rate for Payer: Networks By Design Commercial |
$1,951.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,551.70
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,801.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,501.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,501.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,501.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,501.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$3,002.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$600.40 |
| Max. Negotiated Rate |
$2,551.70 |
| Rate for Payer: Adventist Health Commercial |
$600.40
|
| Rate for Payer: Cash Price |
$1,651.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,200.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,200.80
|
| Rate for Payer: Galaxy Health WC |
$2,551.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,801.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,002.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,143.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,858.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.48
|
| Rate for Payer: Multiplan Commercial |
$2,401.60
|
| Rate for Payer: Networks By Design Commercial |
$1,951.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,551.70
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
OP
|
$7,105.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$1,421.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$3,907.75
|
| Rate for Payer: Cash Price |
$3,907.75
|
| Rate for Payer: Cash Price |
$3,907.75
|
| Rate for Payer: Cigna of CA HMO |
$4,547.20
|
| Rate for Payer: Cigna of CA PPO |
$5,257.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,739.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$4,618.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,263.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,552.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,552.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,552.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,552.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
IP
|
$7,105.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$6,039.25 |
| Rate for Payer: Adventist Health Commercial |
$1,421.00
|
| Rate for Payer: Cash Price |
$3,907.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,739.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,707.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,397.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Networks By Design Commercial |
$4,618.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
IP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
905351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$702.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,338.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.12
|
| Rate for Payer: Multiplan Commercial |
$2,810.40
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
OP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
915351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$843.12 |
| Max. Negotiated Rate |
$3,822.69 |
| Rate for Payer: Adventist Health Commercial |
$1,440.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,932.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,634.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,034.73
|
| Rate for Payer: Blue Shield of California Commercial |
$2,592.59
|
| Rate for Payer: Blue Shield of California EPN |
$1,707.32
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,986.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,986.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,380.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,459.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,459.10
|
| Rate for Payer: Multiplan Commercial |
$2,810.40
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,107.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,107.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,986.05
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
IP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
915351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$702.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,338.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.12
|
| Rate for Payer: Multiplan Commercial |
$2,810.40
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
OP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
905351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$843.12 |
| Max. Negotiated Rate |
$3,822.69 |
| Rate for Payer: Adventist Health Commercial |
$1,440.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,932.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,634.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,034.73
|
| Rate for Payer: Blue Shield of California Commercial |
$2,592.59
|
| Rate for Payer: Blue Shield of California EPN |
$1,707.32
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,986.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,986.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,380.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,459.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,459.10
|
| Rate for Payer: Multiplan Commercial |
$2,810.40
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,107.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,107.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,986.05
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
915356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,111.28
|
| Rate for Payer: Multiplan Commercial |
$7,037.60
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
|
