|
HC EPS ARTERIAL CATH SET
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.81
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC EPS ARTERIAL CATH SET
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC EPS ATRIAL PACING
|
Facility
|
IP
|
$6,025.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,205.00 |
| Max. Negotiated Rate |
$5,121.25 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,410.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.00
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,554.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
|
|
HC EPS ATRIAL PACING
|
Facility
|
OP
|
$6,025.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.88 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$419.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cigna of CA HMO |
$3,856.00
|
| Rate for Payer: Cigna of CA PPO |
$4,458.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$177.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,615.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,615.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
IP
|
$6,025.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,205.00 |
| Max. Negotiated Rate |
$5,121.25 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,410.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.00
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,554.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
OP
|
$6,025.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.88 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cigna of CA HMO |
$3,856.00
|
| Rate for Payer: Cigna of CA PPO |
$4,458.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$177.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,615.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,615.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$8,296.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,659.20 |
| Max. Negotiated Rate |
$7,051.60 |
| Rate for Payer: Adventist Health Commercial |
$1,659.20
|
| Rate for Payer: Cash Price |
$3,733.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,807.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,318.40
|
| Rate for Payer: Galaxy Health WC |
$7,051.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,977.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,267.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,894.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,991.04
|
| Rate for Payer: Multiplan Commercial |
$6,636.80
|
| Rate for Payer: Networks By Design Commercial |
$5,392.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,051.60
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$8,296.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$274.60 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,659.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$591.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$3,733.20
|
| Rate for Payer: Cash Price |
$3,733.20
|
| Rate for Payer: Cash Price |
$3,733.20
|
| Rate for Payer: Cash Price |
$3,733.20
|
| Rate for Payer: Cigna of CA HMO |
$5,309.44
|
| Rate for Payer: Cigna of CA PPO |
$6,139.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,807.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$7,051.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,977.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$274.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,267.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$310.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,991.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$6,636.80
|
| Rate for Payer: Networks By Design Commercial |
$5,392.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,051.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,977.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,977.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
IP
|
$10,702.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,140.40 |
| Max. Negotiated Rate |
$9,096.70 |
| Rate for Payer: Adventist Health Commercial |
$2,140.40
|
| Rate for Payer: Cash Price |
$4,815.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,491.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,280.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,280.80
|
| Rate for Payer: Galaxy Health WC |
$9,096.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,421.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,795.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,314.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,568.48
|
| Rate for Payer: Multiplan Commercial |
$8,561.60
|
| Rate for Payer: Networks By Design Commercial |
$6,956.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,096.70
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
OP
|
$10,702.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$2,140.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,958.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$4,815.90
|
| Rate for Payer: Cash Price |
$4,815.90
|
| Rate for Payer: Cash Price |
$4,815.90
|
| Rate for Payer: Cash Price |
$4,815.90
|
| Rate for Payer: Cigna of CA HMO |
$6,849.28
|
| Rate for Payer: Cigna of CA PPO |
$7,919.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,491.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$9,096.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,421.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,202.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,795.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,359.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,568.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$8,561.60
|
| Rate for Payer: Networks By Design Commercial |
$6,956.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,096.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,421.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,421.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$22,965.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,593.00 |
| Max. Negotiated Rate |
$19,520.25 |
| Rate for Payer: Adventist Health Commercial |
$4,593.00
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,075.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,186.00
|
| Rate for Payer: EPIC Health Plan Senior |
$9,186.00
|
| Rate for Payer: Galaxy Health WC |
$19,520.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,779.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,582.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,549.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,511.60
|
| Rate for Payer: Multiplan Commercial |
$18,372.00
|
| Rate for Payer: Networks By Design Commercial |
$14,927.25
|
| Rate for Payer: Prime Health Services Commercial |
$19,520.25
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$22,965.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$19,520.25 |
| Rate for Payer: Adventist Health Commercial |
$4,593.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,628.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cigna of CA HMO |
$14,697.60
|
| Rate for Payer: Cigna of CA PPO |
$16,994.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,075.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$19,520.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,779.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,174.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,582.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,511.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$18,372.00
|
| Rate for Payer: Networks By Design Commercial |
$14,927.25
|
| Rate for Payer: Prime Health Services Commercial |
$19,520.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,779.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$16,323.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,264.60 |
| Max. Negotiated Rate |
$13,874.55 |
| Rate for Payer: Adventist Health Commercial |
$3,264.60
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,426.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,529.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,529.20
|
| Rate for Payer: Galaxy Health WC |
$13,874.55
|
| Rate for Payer: Global Benefits Group Commercial |
$9,793.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,365.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,630.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,917.52
|
| Rate for Payer: Multiplan Commercial |
$13,058.40
|
| Rate for Payer: Networks By Design Commercial |
$10,609.95
|
| Rate for Payer: Prime Health Services Commercial |
$13,874.55
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$16,323.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$3,264.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,335.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cigna of CA HMO |
$10,446.72
|
| Rate for Payer: Cigna of CA PPO |
$12,079.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,426.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$13,874.55
|
| Rate for Payer: Global Benefits Group Commercial |
$9,793.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,002.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,365.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,133.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,917.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$13,058.40
|
| Rate for Payer: Networks By Design Commercial |
$10,609.95
|
| Rate for Payer: Prime Health Services Commercial |
$13,874.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,793.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,793.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
IP
|
$57,295.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,459.00 |
| Max. Negotiated Rate |
$48,700.75 |
| Rate for Payer: Adventist Health Commercial |
$11,459.00
|
| Rate for Payer: Cash Price |
$25,782.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40,106.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,918.00
|
| Rate for Payer: EPIC Health Plan Senior |
$22,918.00
|
| Rate for Payer: Galaxy Health WC |
$48,700.75
|
| Rate for Payer: Global Benefits Group Commercial |
$34,377.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36,382.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,804.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,750.80
|
| Rate for Payer: Multiplan Commercial |
$45,836.00
|
| Rate for Payer: Networks By Design Commercial |
$37,241.75
|
| Rate for Payer: Prime Health Services Commercial |
$48,700.75
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
OP
|
$57,295.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,479.19 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$11,459.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| Rate for Payer: Cash Price |
$25,782.75
|
| Rate for Payer: Cash Price |
$25,782.75
|
| Rate for Payer: Cash Price |
$25,782.75
|
| Rate for Payer: Cigna of CA HMO |
$37,241.75
|
| Rate for Payer: Cigna of CA PPO |
$42,398.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40,106.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$48,700.75
|
| Rate for Payer: Global Benefits Group Commercial |
$34,377.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,479.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36,382.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,672.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,750.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,358.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$45,836.00
|
| Rate for Payer: Networks By Design Commercial |
$37,241.75
|
| Rate for Payer: Prime Health Services Commercial |
$48,700.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34,377.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34,377.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,647.50
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$40,389.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,077.80 |
| Max. Negotiated Rate |
$34,330.65 |
| Rate for Payer: Adventist Health Commercial |
$8,077.80
|
| Rate for Payer: Cash Price |
$18,175.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,272.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$16,155.60
|
| Rate for Payer: Galaxy Health WC |
$34,330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$24,233.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,647.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,829.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,693.36
|
| Rate for Payer: Multiplan Commercial |
$32,311.20
|
| Rate for Payer: Networks By Design Commercial |
$26,252.85
|
| Rate for Payer: Prime Health Services Commercial |
$34,330.65
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
OP
|
$40,389.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,107.89 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$8,077.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| Rate for Payer: Cash Price |
$18,175.05
|
| Rate for Payer: Cash Price |
$18,175.05
|
| Rate for Payer: Cash Price |
$18,175.05
|
| Rate for Payer: Cigna of CA HMO |
$26,252.85
|
| Rate for Payer: Cigna of CA PPO |
$29,887.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,272.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$34,330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$24,233.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,107.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,647.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,693.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,358.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$32,311.20
|
| Rate for Payer: Networks By Design Commercial |
$26,252.85
|
| Rate for Payer: Prime Health Services Commercial |
$34,330.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,233.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24,233.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,194.50
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$37,604.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,478.77 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$7,520.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| Rate for Payer: Cash Price |
$16,921.80
|
| Rate for Payer: Cash Price |
$16,921.80
|
| Rate for Payer: Cash Price |
$16,921.80
|
| Rate for Payer: Cigna of CA HMO |
$24,442.60
|
| Rate for Payer: Cigna of CA PPO |
$27,826.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,322.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$31,963.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22,562.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,478.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,878.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,024.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,358.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$30,083.20
|
| Rate for Payer: Networks By Design Commercial |
$24,442.60
|
| Rate for Payer: Prime Health Services Commercial |
$31,963.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,562.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,562.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,802.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$37,604.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,520.80 |
| Max. Negotiated Rate |
$31,963.40 |
| Rate for Payer: Adventist Health Commercial |
$7,520.80
|
| Rate for Payer: Cash Price |
$16,921.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,322.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,041.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15,041.60
|
| Rate for Payer: Galaxy Health WC |
$31,963.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22,562.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,878.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22,186.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,024.96
|
| Rate for Payer: Multiplan Commercial |
$30,083.20
|
| Rate for Payer: Networks By Design Commercial |
$24,442.60
|
| Rate for Payer: Prime Health Services Commercial |
$31,963.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$6,025.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,205.00 |
| Max. Negotiated Rate |
$5,121.25 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,410.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.00
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,554.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$6,025.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$98.23 |
| Max. Negotiated Rate |
$7,196.06 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cigna of CA HMO |
$3,856.00
|
| Rate for Payer: Cigna of CA PPO |
$4,458.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$137.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,973.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,615.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,615.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$6,025.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,205.00 |
| Max. Negotiated Rate |
$5,121.25 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,410.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.00
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,554.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$6,025.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$157.05 |
| Max. Negotiated Rate |
$7,196.06 |
| Rate for Payer: Adventist Health Commercial |
$1,205.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cash Price |
$2,711.25
|
| Rate for Payer: Cigna of CA HMO |
$3,856.00
|
| Rate for Payer: Cigna of CA PPO |
$4,458.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,217.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$5,121.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,615.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$157.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,825.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,446.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,973.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$4,820.00
|
| Rate for Payer: Networks By Design Commercial |
$3,916.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,121.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,615.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,615.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$10,363.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$479.84 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$2,072.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$574.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cigna of CA HMO |
$6,632.32
|
| Rate for Payer: Cigna of CA PPO |
$7,668.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,254.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$8,808.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,217.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$479.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,580.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,487.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$8,290.40
|
| Rate for Payer: Networks By Design Commercial |
$6,735.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,808.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,217.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,217.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
