|
HC EPS CATH ABLATION OF AV NODE
|
Facility
OP
|
$10,948.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$15,302.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,568.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cigna of CA HMO |
$7,006.72
|
| Rate for Payer: Cigna of CA PPO |
$8,101.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$9,305.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,568.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,211.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,302.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$15,302.84
|
| Rate for Payer: IEHP Medi-Cal |
$15,116.22
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15,116.22
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,302.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$8,758.40
|
| Rate for Payer: Networks By Design Commercial |
$7,116.20
|
| Rate for Payer: Prime Health Services Commercial |
$9,305.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,568.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,568.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,568.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
IP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,638.56 |
| Max. Negotiated Rate |
$19,969.90 |
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,397.60
|
| Rate for Payer: Galaxy Health WC |
$19,969.90
|
| Rate for Payer: Global Benefits Group Commercial |
$14,096.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,670.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,951.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,638.56
|
| Rate for Payer: Multiplan Commercial |
$18,795.20
|
| Rate for Payer: Networks By Design Commercial |
$15,271.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,969.90
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
OP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$19,969.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$14,096.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cigna of CA HMO |
$15,036.16
|
| Rate for Payer: Cigna of CA PPO |
$17,385.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$19,969.90
|
| Rate for Payer: Global Benefits Group Commercial |
$14,096.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,620.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,302.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$15,302.84
|
| Rate for Payer: IEHP Medi-Cal |
$15,116.22
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15,116.22
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,670.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,638.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$18,795.20
|
| Rate for Payer: Networks By Design Commercial |
$15,271.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,969.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,500.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,096.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
OP
|
$16,699.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$15,302.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,019.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: Cigna of CA HMO |
$10,687.36
|
| Rate for Payer: Cigna of CA PPO |
$12,357.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$14,194.15
|
| Rate for Payer: Global Benefits Group Commercial |
$10,019.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,524.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,302.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$15,302.84
|
| Rate for Payer: IEHP Medi-Cal |
$15,116.22
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15,116.22
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,138.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,007.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$13,359.20
|
| Rate for Payer: Networks By Design Commercial |
$10,854.35
|
| Rate for Payer: Prime Health Services Commercial |
$14,194.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,019.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,019.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,019.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
IP
|
$16,699.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,007.76 |
| Max. Negotiated Rate |
$14,194.15 |
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,679.60
|
| Rate for Payer: Galaxy Health WC |
$14,194.15
|
| Rate for Payer: Global Benefits Group Commercial |
$10,019.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,138.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,362.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,007.76
|
| Rate for Payer: Multiplan Commercial |
$13,359.20
|
| Rate for Payer: Networks By Design Commercial |
$10,854.35
|
| Rate for Payer: Prime Health Services Commercial |
$14,194.15
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
IP
|
$58,614.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,067.36 |
| Max. Negotiated Rate |
$49,821.90 |
| Rate for Payer: Cash Price |
$26,376.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,445.60
|
| Rate for Payer: Galaxy Health WC |
$49,821.90
|
| Rate for Payer: Global Benefits Group Commercial |
$35,168.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39,095.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,331.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,067.36
|
| Rate for Payer: Multiplan Commercial |
$46,891.20
|
| Rate for Payer: Networks By Design Commercial |
$38,099.10
|
| Rate for Payer: Prime Health Services Commercial |
$49,821.90
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
OP
|
$58,614.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,672.89 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$35,168.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,058.23
|
| Rate for Payer: Blue Shield of California EPN |
$5,244.75
|
| Rate for Payer: Cash Price |
$26,376.30
|
| Rate for Payer: Cash Price |
$26,376.30
|
| Rate for Payer: Cigna of CA PPO |
$43,374.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$49,821.90
|
| Rate for Payer: Global Benefits Group Commercial |
$35,168.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43,960.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$48,666.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$48,666.28
|
| Rate for Payer: IEHP Medi-Cal |
$48,072.79
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$48,072.79
|
| Rate for Payer: IEHP Medicare Advantage |
$29,674.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39,095.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,067.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,389.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$46,891.20
|
| Rate for Payer: Networks By Design Commercial |
$38,099.10
|
| Rate for Payer: Prime Health Services Commercial |
$49,821.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$35,168.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35,168.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35,168.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
OP
|
$41,319.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,252.97 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$24,791.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,058.23
|
| Rate for Payer: Blue Shield of California EPN |
$5,244.75
|
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Cigna of CA PPO |
$30,576.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$35,121.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24,791.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30,989.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$48,666.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$48,666.28
|
| Rate for Payer: IEHP Medi-Cal |
$48,072.79
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$48,072.79
|
| Rate for Payer: IEHP Medicare Advantage |
$29,674.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,559.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,916.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,389.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$33,055.20
|
| Rate for Payer: Networks By Design Commercial |
$26,857.35
|
| Rate for Payer: Prime Health Services Commercial |
$35,121.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24,791.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,791.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24,791.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
IP
|
$41,319.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,916.56 |
| Max. Negotiated Rate |
$35,121.15 |
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,527.60
|
| Rate for Payer: Galaxy Health WC |
$35,121.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24,791.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,559.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,742.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,916.56
|
| Rate for Payer: Multiplan Commercial |
$33,055.20
|
| Rate for Payer: Networks By Design Commercial |
$26,857.35
|
| Rate for Payer: Prime Health Services Commercial |
$35,121.15
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
OP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,672.42 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$23,082.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,058.23
|
| Rate for Payer: Blue Shield of California EPN |
$5,244.75
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Cigna of CA PPO |
$28,467.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28,852.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$48,666.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$48,666.28
|
| Rate for Payer: IEHP Medi-Cal |
$48,072.79
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$48,072.79
|
| Rate for Payer: IEHP Medicare Advantage |
$29,674.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,389.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$30,776.00
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23,082.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,082.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
IP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,232.80 |
| Max. Negotiated Rate |
$32,699.50 |
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,388.00
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,657.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,232.80
|
| Rate for Payer: Multiplan Commercial |
$30,776.00
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$91.42 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,438.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,438.66
|
| Rate for Payer: IEHP Medi-Cal |
$2,408.92
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$2,408.92
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,479.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,931.20
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,479.36 |
| Max. Negotiated Rate |
$5,239.40 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,479.36
|
| Rate for Payer: Multiplan Commercial |
$4,931.20
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,479.36 |
| Max. Negotiated Rate |
$5,239.40 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,479.36
|
| Rate for Payer: Multiplan Commercial |
$4,931.20
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$151.14 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$151.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,438.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,438.66
|
| Rate for Payer: IEHP Medi-Cal |
$2,408.92
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$2,408.92
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,479.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,931.20
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
IP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,544.48 |
| Max. Negotiated Rate |
$9,011.70 |
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,240.80
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,039.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,544.48
|
| Rate for Payer: Multiplan Commercial |
$8,481.60
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
OP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$534.28 |
| Max. Negotiated Rate |
$15,302.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$534.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,361.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cigna of CA HMO |
$6,785.28
|
| Rate for Payer: Cigna of CA PPO |
$7,845.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,951.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,302.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$15,302.84
|
| Rate for Payer: IEHP Medi-Cal |
$15,116.22
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15,116.22
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,544.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$8,481.60
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,361.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,361.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,361.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
IP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,320.64 |
| Max. Negotiated Rate |
$11,760.60 |
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,271.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,320.64
|
| Rate for Payer: Multiplan Commercial |
$11,068.80
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
OP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$11,760.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,760.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,609.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,609.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$8,301.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cigna of CA HMO |
$8,855.04
|
| Rate for Payer: Cigna of CA PPO |
$10,238.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Dignity Health Media |
$11,760.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,760.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10,377.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,320.64
|
| Rate for Payer: Multiplan Commercial |
$11,068.80
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8,301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,301.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,301.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,760.60
|
| Rate for Payer: Vantage Medical Group Senior |
$11,760.60
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
IP
|
$8,975.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,154.00 |
| Max. Negotiated Rate |
$7,628.75 |
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,590.00
|
| Rate for Payer: Galaxy Health WC |
$7,628.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,385.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,986.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,419.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.00
|
| Rate for Payer: Multiplan Commercial |
$7,180.00
|
| Rate for Payer: Networks By Design Commercial |
$5,833.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,628.75
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
OP
|
$8,975.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$11,370.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,628.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,936.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,936.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,385.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cigna of CA HMO |
$5,744.00
|
| Rate for Payer: Cigna of CA PPO |
$6,641.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Dignity Health Media |
$7,628.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,628.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,590.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,590.00
|
| Rate for Payer: Galaxy Health WC |
$7,628.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,385.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,731.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,986.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.00
|
| Rate for Payer: Multiplan Commercial |
$7,180.00
|
| Rate for Payer: Networks By Design Commercial |
$5,833.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,628.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,385.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,385.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,385.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,628.75
|
| Rate for Payer: Vantage Medical Group Senior |
$7,628.75
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
IP
|
$11,581.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,779.44 |
| Max. Negotiated Rate |
$9,843.85 |
| Rate for Payer: Cash Price |
$5,211.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,632.40
|
| Rate for Payer: Galaxy Health WC |
$9,843.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,948.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,724.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,412.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,779.44
|
| Rate for Payer: Multiplan Commercial |
$9,264.80
|
| Rate for Payer: Networks By Design Commercial |
$7,527.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,843.85
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
OP
|
$11,581.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$372.57 |
| Max. Negotiated Rate |
$9,843.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$372.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,843.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6,369.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,369.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,948.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$5,211.45
|
| Rate for Payer: Cash Price |
$5,211.45
|
| Rate for Payer: Cash Price |
$5,211.45
|
| Rate for Payer: Cigna of CA HMO |
$7,411.84
|
| Rate for Payer: Cigna of CA PPO |
$8,569.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,843.85
|
| Rate for Payer: Dignity Health Media |
$9,843.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,843.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,632.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,632.40
|
| Rate for Payer: Galaxy Health WC |
$9,843.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,948.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,685.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,724.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,779.44
|
| Rate for Payer: Multiplan Commercial |
$9,264.80
|
| Rate for Payer: Networks By Design Commercial |
$7,527.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,843.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,948.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,948.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,948.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,843.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,843.85
|
| Rate for Payer: Vantage Medical Group Senior |
$9,843.85
|
|
|
HC EPS RV RECORDING
|
Facility
IP
|
$7,409.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,778.16 |
| Max. Negotiated Rate |
$6,297.65 |
| Rate for Payer: Cash Price |
$3,334.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,963.60
|
| Rate for Payer: Galaxy Health WC |
$6,297.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,445.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,941.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,822.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,778.16
|
| Rate for Payer: Multiplan Commercial |
$5,927.20
|
| Rate for Payer: Networks By Design Commercial |
$4,815.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,297.65
|
|
|
HC EPS RV RECORDING
|
Facility
OP
|
$7,409.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$302.69 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$481.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,445.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,334.05
|
| Rate for Payer: Cash Price |
$3,334.05
|
| Rate for Payer: Cash Price |
$3,334.05
|
| Rate for Payer: Cigna of CA HMO |
$4,741.76
|
| Rate for Payer: Cigna of CA PPO |
$5,482.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$6,297.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,445.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,556.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,438.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,438.66
|
| Rate for Payer: IEHP Medi-Cal |
$2,408.92
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$2,408.92
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,941.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$302.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,778.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$5,927.20
|
| Rate for Payer: Networks By Design Commercial |
$4,815.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,297.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,445.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
