|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
OP
|
$3,630.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.37 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,488.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$590.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,633.50
|
| Rate for Payer: Cash Price |
$1,633.50
|
| Rate for Payer: Cash Price |
$1,633.50
|
| 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 |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,541.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| 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/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,305.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,615.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,718.08
|
| 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: TriValley Medical Group Commercial/Senior |
$2,178.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
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 |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$726.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,633.50
|
| Rate for Payer: Cash Price |
$1,633.50
|
| Rate for Payer: Cash Price |
$1,633.50
|
| 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 |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,541.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| 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/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,305.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,615.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,718.08
|
| 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 |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
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 |
$6,779.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,545.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9,566.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,888.35
|
| 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
|
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 |
$6,779.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,545.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9,566.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,888.35
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$6,779.25
|
| Rate for Payer: Cash Price |
$6,779.25
|
| Rate for Payer: Cash Price |
$6,779.25
|
| 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 |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,545.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| 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/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$294.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,566.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| 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 |
$7,532.50
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
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 |
$17,561.82 |
| Rate for Payer: Adventist Health Commercial |
$3,013.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$6,779.25
|
| Rate for Payer: Cash Price |
$6,779.25
|
| Rate for Payer: Cash Price |
$6,779.25
|
| 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 |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,545.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| 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/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,566.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,441.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,615.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
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 |
$6,456.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,042.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9,110.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,464.73
|
| 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
|
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 |
$6,456.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,042.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9,110.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,464.73
|
| 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
|
361
|
| Min. Negotiated Rate |
$437.82 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$6,456.15
|
| Rate for Payer: Cash Price |
$6,456.15
|
| Rate for Payer: Cash Price |
$6,456.15
|
| 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 |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,042.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| 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/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$437.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,110.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| 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 |
$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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
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 |
$17,561.82 |
| Rate for Payer: Adventist Health Commercial |
$2,869.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$6,456.15
|
| Rate for Payer: Cash Price |
$6,456.15
|
| Rate for Payer: Cash Price |
$6,456.15
|
| 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 |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,042.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| 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/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,110.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,441.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,443.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$3,002.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$600.40 |
| Max. Negotiated Rate |
$2,551.70 |
| Rate for Payer: Adventist Health Commercial |
$600.40
|
| Rate for Payer: Cash Price |
$1,350.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,101.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,906.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,771.18
|
| 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 TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$3,002.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,230.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,350.90
|
| Rate for Payer: Cash Price |
$1,350.90
|
| Rate for Payer: Cash Price |
$1,350.90
|
| 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 |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,101.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| 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/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,906.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$913.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,071.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,139.11
|
| 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: TriValley Medical Group Commercial/Senior |
$1,801.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
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 |
$5,641.00 |
| 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 |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,350.90
|
| Rate for Payer: Cash Price |
$1,350.90
|
| Rate for Payer: Cash Price |
$1,350.90
|
| 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 |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,101.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| 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/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,906.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$913.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,071.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,139.11
|
| 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 |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
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 |
$1,350.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,101.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,906.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,771.18
|
| 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
|
IP
|
$7,105.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
456
|
| 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 |
$3,197.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| 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 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 |
$3,197.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| 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 TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
OP
|
$7,105.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$6,039.25 |
| Rate for Payer: Adventist Health Commercial |
$2,913.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,371.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| 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/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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: TriValley Medical Group Commercial/Senior |
$4,263.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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 |
$6,039.25 |
| Rate for Payer: Adventist Health Commercial |
$1,421.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| 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/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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 |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$2,230.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,072.67
|
| 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 |
$2,283.45
|
| 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 |
$2,126.42
|
| Rate for Payer: Blue Shield of California Commercial |
$2,701.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,781.09
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cash Price |
$1,580.85
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,380.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,230.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,072.67
|
| 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
|
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 |
$2,126.42
|
| Rate for Payer: Blue Shield of California Commercial |
$2,701.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,781.09
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cash Price |
$1,580.85
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,380.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,230.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,072.67
|
| 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cash Price |
$1,580.85
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$2,230.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,072.67
|
| 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 |
$2,283.45
|
| 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 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$3,958.65
|
| Rate for Payer: Cash Price |
$3,958.65
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$5,586.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,190.23
|
| 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 |
$5,718.05
|
| 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
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
OP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,111.28 |
| Max. Negotiated Rate |
$7,477.45 |
| Rate for Payer: Adventist Health Commercial |
$3,606.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,838.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,597.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,324.82
|
| Rate for Payer: Blue Shield of California Commercial |
$4,460.08
|
| Rate for Payer: Blue Shield of California Commercial |
$6,764.89
|
| Rate for Payer: Cash Price |
$3,958.65
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,477.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,477.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$5,586.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,190.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,111.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,157.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,157.90
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$5,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,278.20
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,477.45
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$3,958.65
|
| Rate for Payer: Cash Price |
$3,958.65
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$5,586.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,190.23
|
| 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 |
$5,718.05
|
| 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
|
|
