|
HC P32 CHROMIC PHOSPHATE PER MCI
|
Facility
OP
|
$24,554.00
|
|
|
Service Code
|
CPT A9564
|
| Hospital Charge Code |
909301556
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$998.68 |
| Max. Negotiated Rate |
$20,870.90 |
| Rate for Payer: Cigna of CA HMO |
$15,714.56
|
| Rate for Payer: Cigna of CA PPO |
$18,169.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,801.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,870.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13,504.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,504.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,535.34
|
| Rate for Payer: BCBS Transplant Transplant |
$14,732.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14,511.41
|
| Rate for Payer: Blue Shield of California EPN |
$11,515.83
|
| Rate for Payer: Cash Price |
$11,049.30
|
| Rate for Payer: Cash Price |
$11,049.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,870.90
|
| Rate for Payer: Dignity Health Media |
$20,870.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,870.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,821.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,821.60
|
| Rate for Payer: Galaxy Health WC |
$20,870.90
|
| Rate for Payer: Global Benefits Group Commercial |
$14,732.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,415.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,377.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$998.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,892.96
|
| Rate for Payer: Multiplan Commercial |
$19,643.20
|
| Rate for Payer: Networks By Design Commercial |
$15,960.10
|
| Rate for Payer: Prime Health Services Commercial |
$20,870.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14,732.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,732.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,732.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,277.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,277.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,277.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,277.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,870.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,870.90
|
| Rate for Payer: Vantage Medical Group Senior |
$20,870.90
|
|
|
HC P32 CHROMIC PHOSPHATE PER MCI
|
Facility
IP
|
$24,554.00
|
|
|
Service Code
|
CPT A9564
|
| Hospital Charge Code |
909301556
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$5,892.96 |
| Max. Negotiated Rate |
$20,870.90 |
| Rate for Payer: Cash Price |
$11,049.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,821.60
|
| Rate for Payer: Galaxy Health WC |
$20,870.90
|
| Rate for Payer: Global Benefits Group Commercial |
$14,732.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,377.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,355.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,892.96
|
| Rate for Payer: Multiplan Commercial |
$19,643.20
|
| Rate for Payer: Networks By Design Commercial |
$15,960.10
|
| Rate for Payer: Prime Health Services Commercial |
$20,870.90
|
|
|
HC P32 SODIUM PHOSPHATE PER MCI
|
Facility
OP
|
$4,892.00
|
|
|
Service Code
|
CPT A9563
|
| Hospital Charge Code |
909301555
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$151.65 |
| Max. Negotiated Rate |
$4,158.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,890.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,158.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,690.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,690.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.65
|
| Rate for Payer: BCBS Transplant Transplant |
$2,935.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,891.17
|
| Rate for Payer: Blue Shield of California EPN |
$2,294.35
|
| Rate for Payer: Cash Price |
$2,201.40
|
| Rate for Payer: Cash Price |
$2,201.40
|
| Rate for Payer: Cigna of CA HMO |
$3,130.88
|
| Rate for Payer: Cigna of CA PPO |
$3,620.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,158.20
|
| Rate for Payer: Dignity Health Media |
$4,158.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,158.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,956.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,956.80
|
| Rate for Payer: Galaxy Health WC |
$4,158.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,935.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,669.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,262.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,174.08
|
| Rate for Payer: Multiplan Commercial |
$3,913.60
|
| Rate for Payer: Networks By Design Commercial |
$3,179.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,158.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,935.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,935.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,935.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,446.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,446.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,446.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,446.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,158.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,158.20
|
| Rate for Payer: Vantage Medical Group Senior |
$4,158.20
|
|
|
HC P32 SODIUM PHOSPHATE PER MCI
|
Facility
IP
|
$4,892.00
|
|
|
Service Code
|
CPT A9563
|
| Hospital Charge Code |
909301555
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,174.08 |
| Max. Negotiated Rate |
$4,158.20 |
| Rate for Payer: Blue Shield of California Commercial |
$3,483.10
|
| Rate for Payer: Blue Shield of California EPN |
$2,504.70
|
| Rate for Payer: Cash Price |
$2,201.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,956.80
|
| Rate for Payer: Galaxy Health WC |
$4,158.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,935.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,262.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,863.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,174.08
|
| Rate for Payer: Multiplan Commercial |
$3,913.60
|
| Rate for Payer: Networks By Design Commercial |
$3,179.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,158.20
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906811421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,562.32 |
| Max. Negotiated Rate |
$23,241.55 |
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,937.20
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,417.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,562.32
|
| Rate for Payer: Multiplan Commercial |
$21,874.40
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
OP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906811421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$553.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,405.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cigna of CA PPO |
$20,233.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,507.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,926.60
|
| Rate for Payer: Heritage Provider Network Transplant |
$39,926.60
|
| Rate for Payer: IEHP Medi-Cal |
$39,439.69
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$39,439.69
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$553.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,562.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$21,874.40
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,405.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,405.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
IP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,636.96 |
| Max. Negotiated Rate |
$23,505.90 |
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,061.60
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,536.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,636.96
|
| Rate for Payer: Multiplan Commercial |
$22,123.20
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
OP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$550.60 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,592.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cigna of CA PPO |
$20,463.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,740.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,636.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$22,123.20
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,592.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,592.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
IP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,716.00 |
| Max. Negotiated Rate |
$27,327.50 |
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,860.00
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,249.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,716.00
|
| Rate for Payer: Multiplan Commercial |
$25,720.00
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
OP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.81 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$19,290.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cigna of CA PPO |
$23,791.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,112.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,926.60
|
| Rate for Payer: Heritage Provider Network Transplant |
$39,926.60
|
| Rate for Payer: IEHP Medi-Cal |
$39,439.69
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$39,439.69
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,716.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$25,720.00
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,290.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,290.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
OP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$13,639.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cigna of CA PPO |
$16,822.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,049.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,408.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$17,408.26
|
| Rate for Payer: IEHP Medi-Cal |
$17,195.96
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$17,195.96
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,455.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$18,186.40
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13,639.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,639.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
IP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,455.92 |
| Max. Negotiated Rate |
$19,323.05 |
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,093.20
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,661.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,455.92
|
| Rate for Payer: Multiplan Commercial |
$18,186.40
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
IP
|
$9,779.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,346.96 |
| Max. Negotiated Rate |
$8,312.15 |
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,911.60
|
| Rate for Payer: Galaxy Health WC |
$8,312.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,867.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,522.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,725.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,346.96
|
| Rate for Payer: Multiplan Commercial |
$7,823.20
|
| Rate for Payer: Networks By Design Commercial |
$6,356.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,312.15
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
OP
|
$9,779.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.68 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,867.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Cigna of CA PPO |
$7,236.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$8,312.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,867.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,334.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,408.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$17,408.26
|
| Rate for Payer: IEHP Medi-Cal |
$17,195.96
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$17,195.96
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,522.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,346.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$7,823.20
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$6,356.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,312.15
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,867.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,867.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
OP
|
$27,343.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$676.25 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,405.80
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cigna of CA PPO |
$20,233.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,507.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,562.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$21,874.40
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,405.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,405.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,562.32 |
| Max. Negotiated Rate |
$23,241.55 |
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,937.20
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,417.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,562.32
|
| Rate for Payer: Multiplan Commercial |
$21,874.40
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
OP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.94 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,744.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cigna of CA PPO |
$19,417.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$22,304.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,744.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,680.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,408.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$17,408.26
|
| Rate for Payer: IEHP Medi-Cal |
$17,195.96
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$17,195.96
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,502.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,297.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$20,992.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$17,056.00
|
| Rate for Payer: Prime Health Services Commercial |
$22,304.00
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,744.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,744.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
IP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,297.60 |
| Max. Negotiated Rate |
$22,304.00 |
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,496.00
|
| Rate for Payer: Galaxy Health WC |
$22,304.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,744.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,502.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,997.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,297.60
|
| Rate for Payer: Multiplan Commercial |
$20,992.00
|
| Rate for Payer: Networks By Design Commercial |
$17,056.00
|
| Rate for Payer: Prime Health Services Commercial |
$22,304.00
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
OP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,414.74 |
| 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 |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$17,251.80
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cigna of CA PPO |
$21,277.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$24,440.05
|
| Rate for Payer: Global Benefits Group Commercial |
$17,251.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,564.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,178.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,900.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$23,002.40
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$18,689.45
|
| Rate for Payer: Prime Health Services Commercial |
$24,440.05
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17,251.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,251.80
|
| 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 |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
IP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,900.72 |
| Max. Negotiated Rate |
$24,440.05 |
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,501.20
|
| Rate for Payer: Galaxy Health WC |
$24,440.05
|
| Rate for Payer: Global Benefits Group Commercial |
$17,251.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,178.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,954.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,900.72
|
| Rate for Payer: Multiplan Commercial |
$23,002.40
|
| Rate for Payer: Networks By Design Commercial |
$18,689.45
|
| Rate for Payer: Prime Health Services Commercial |
$24,440.05
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
IP
|
$29,667.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,120.08 |
| Max. Negotiated Rate |
$25,216.95 |
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,866.80
|
| Rate for Payer: Galaxy Health WC |
$25,216.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,800.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,787.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,303.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,120.08
|
| Rate for Payer: Multiplan Commercial |
$23,733.60
|
| Rate for Payer: Networks By Design Commercial |
$19,283.55
|
| Rate for Payer: Prime Health Services Commercial |
$25,216.95
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
OP
|
$29,667.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,414.74 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$17,800.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cigna of CA PPO |
$21,953.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$25,216.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,800.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22,250.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,787.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,120.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$23,733.60
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$19,283.55
|
| Rate for Payer: Prime Health Services Commercial |
$25,216.95
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17,800.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,800.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
OP
|
$31,226.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,414.74 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$18,735.60
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cigna of CA PPO |
$23,107.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$26,542.10
|
| Rate for Payer: Global Benefits Group Commercial |
$18,735.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23,419.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,827.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,494.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$24,980.80
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$20,296.90
|
| Rate for Payer: Prime Health Services Commercial |
$26,542.10
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18,735.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,735.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
IP
|
$31,226.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,494.24 |
| Max. Negotiated Rate |
$26,542.10 |
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,490.40
|
| Rate for Payer: Galaxy Health WC |
$26,542.10
|
| Rate for Payer: Global Benefits Group Commercial |
$18,735.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,827.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,897.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,494.24
|
| Rate for Payer: Multiplan Commercial |
$24,980.80
|
| Rate for Payer: Networks By Design Commercial |
$20,296.90
|
| Rate for Payer: Prime Health Services Commercial |
$26,542.10
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.68 |
| Max. Negotiated Rate |
$5,063.45 |
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.80
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.68
|
| Rate for Payer: Multiplan Commercial |
$4,765.60
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
|
