|
HC ICD POCKET REVISION/RELOC
|
Facility
|
IP
|
$4,336.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$867.20 |
| Max. Negotiated Rate |
$3,685.60 |
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,734.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,734.40
|
| Rate for Payer: Galaxy Health WC |
$3,685.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,601.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,892.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,652.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,683.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Multiplan Commercial |
$3,468.80
|
| Rate for Payer: Networks By Design Commercial |
$2,818.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,685.60
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$69,742.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$526.65 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$13,948.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$31,383.90
|
| Rate for Payer: Cash Price |
$31,383.90
|
| Rate for Payer: Cash Price |
$31,383.90
|
| Rate for Payer: Cigna of CA HMO |
$44,634.88
|
| Rate for Payer: Cigna of CA PPO |
$51,609.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$59,280.70
|
| Rate for Payer: Global Benefits Group Commercial |
$41,845.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$526.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46,517.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$595.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,738.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$55,793.60
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$45,332.30
|
| Rate for Payer: Prime Health Services Commercial |
$59,280.70
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41,845.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$67,780.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,556.00 |
| Max. Negotiated Rate |
$57,613.00 |
| Rate for Payer: Adventist Health Commercial |
$13,556.00
|
| Rate for Payer: Cash Price |
$30,501.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,112.00
|
| Rate for Payer: EPIC Health Plan Senior |
$27,112.00
|
| Rate for Payer: Galaxy Health WC |
$57,613.00
|
| Rate for Payer: Global Benefits Group Commercial |
$40,668.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45,209.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25,824.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41,955.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,267.20
|
| Rate for Payer: Multiplan Commercial |
$54,224.00
|
| Rate for Payer: Networks By Design Commercial |
$44,057.00
|
| Rate for Payer: Prime Health Services Commercial |
$57,613.00
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$67,780.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$526.65 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$13,556.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$30,501.00
|
| Rate for Payer: Cash Price |
$30,501.00
|
| Rate for Payer: Cash Price |
$30,501.00
|
| Rate for Payer: Cigna of CA HMO |
$43,379.20
|
| Rate for Payer: Cigna of CA PPO |
$50,157.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$57,613.00
|
| Rate for Payer: Global Benefits Group Commercial |
$40,668.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$526.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45,209.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$595.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,267.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$54,224.00
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$44,057.00
|
| Rate for Payer: Prime Health Services Commercial |
$57,613.00
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40,668.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$69,742.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,948.40 |
| Max. Negotiated Rate |
$59,280.70 |
| Rate for Payer: Adventist Health Commercial |
$13,948.40
|
| Rate for Payer: Cash Price |
$31,383.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,896.80
|
| Rate for Payer: EPIC Health Plan Senior |
$27,896.80
|
| Rate for Payer: Galaxy Health WC |
$59,280.70
|
| Rate for Payer: Global Benefits Group Commercial |
$41,845.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46,517.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26,571.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$43,170.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,738.08
|
| Rate for Payer: Multiplan Commercial |
$55,793.60
|
| Rate for Payer: Networks By Design Commercial |
$45,332.30
|
| Rate for Payer: Prime Health Services Commercial |
$59,280.70
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$92,988.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,597.60 |
| Max. Negotiated Rate |
$79,039.80 |
| Rate for Payer: Adventist Health Commercial |
$18,597.60
|
| Rate for Payer: Cash Price |
$41,844.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,195.20
|
| Rate for Payer: EPIC Health Plan Senior |
$37,195.20
|
| Rate for Payer: Galaxy Health WC |
$79,039.80
|
| Rate for Payer: Global Benefits Group Commercial |
$55,792.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62,023.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35,428.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57,559.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,317.12
|
| Rate for Payer: Multiplan Commercial |
$74,390.40
|
| Rate for Payer: Networks By Design Commercial |
$60,442.20
|
| Rate for Payer: Prime Health Services Commercial |
$79,039.80
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$90,373.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906820217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,074.60 |
| Max. Negotiated Rate |
$76,817.05 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36,149.20
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34,432.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55,940.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21,689.52
|
| Rate for Payer: Multiplan Commercial |
$72,298.40
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$90,373.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906820217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.03 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cigna of CA HMO |
$57,838.72
|
| Rate for Payer: Cigna of CA PPO |
$66,876.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$546.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$617.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21,689.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$72,298.40
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54,223.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$92,988.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.03 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,597.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$41,844.60
|
| Rate for Payer: Cash Price |
$41,844.60
|
| Rate for Payer: Cash Price |
$41,844.60
|
| Rate for Payer: Cigna of CA HMO |
$59,512.32
|
| Rate for Payer: Cigna of CA PPO |
$68,811.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$79,039.80
|
| Rate for Payer: Global Benefits Group Commercial |
$55,792.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$546.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62,023.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$617.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,317.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$74,390.40
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$60,442.20
|
| Rate for Payer: Prime Health Services Commercial |
$79,039.80
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55,792.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$65,554.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$13,110.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$29,499.30
|
| Rate for Payer: Cash Price |
$29,499.30
|
| Rate for Payer: Cash Price |
$29,499.30
|
| Rate for Payer: Cigna of CA HMO |
$41,954.56
|
| Rate for Payer: Cigna of CA PPO |
$48,509.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$55,720.90
|
| Rate for Payer: Global Benefits Group Commercial |
$39,332.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43,724.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,732.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$52,443.20
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$42,610.10
|
| Rate for Payer: Prime Health Services Commercial |
$55,720.90
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,332.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$42,700.95
|
| Rate for Payer: Cash Price |
$42,700.95
|
| Rate for Payer: Cash Price |
$42,700.95
|
| Rate for Payer: Cigna of CA HMO |
$60,730.24
|
| Rate for Payer: Cigna of CA PPO |
$70,219.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,773.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$75,912.80
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56,934.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$65,554.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,110.80 |
| Max. Negotiated Rate |
$55,720.90 |
| Rate for Payer: Adventist Health Commercial |
$13,110.80
|
| Rate for Payer: Cash Price |
$29,499.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,221.60
|
| Rate for Payer: EPIC Health Plan Senior |
$26,221.60
|
| Rate for Payer: Galaxy Health WC |
$55,720.90
|
| Rate for Payer: Global Benefits Group Commercial |
$39,332.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43,724.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24,976.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,577.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,732.96
|
| Rate for Payer: Multiplan Commercial |
$52,443.20
|
| Rate for Payer: Networks By Design Commercial |
$42,610.10
|
| Rate for Payer: Prime Health Services Commercial |
$55,720.90
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,978.20 |
| Max. Negotiated Rate |
$80,657.35 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Cash Price |
$42,700.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,956.40
|
| Rate for Payer: EPIC Health Plan Senior |
$37,956.40
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36,153.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58,737.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,773.84
|
| Rate for Payer: Multiplan Commercial |
$75,912.80
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$5,036.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$1,007.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,303.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,769.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,777.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,092.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$2,266.20
|
| Rate for Payer: Cash Price |
$2,266.20
|
| Rate for Payer: Cash Price |
$2,266.20
|
| Rate for Payer: Cigna of CA HMO |
$3,223.04
|
| Rate for Payer: Cigna of CA PPO |
$3,726.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,280.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,280.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,014.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,014.40
|
| Rate for Payer: Galaxy Health WC |
$4,280.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$454.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,359.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,117.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,525.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,525.20
|
| Rate for Payer: Multiplan Commercial |
$4,028.80
|
| Rate for Payer: Networks By Design Commercial |
$3,273.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,280.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,021.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,021.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,280.60
|
| Rate for Payer: Vantage Medical Group Senior |
$4,280.60
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$7,950.90 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,135.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,144.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,015.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,744.29
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$4,209.30
|
| Rate for Payer: Cash Price |
$4,209.30
|
| Rate for Payer: Cash Price |
$4,209.30
|
| Rate for Payer: Cigna of CA HMO |
$5,986.56
|
| Rate for Payer: Cigna of CA PPO |
$6,921.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,950.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$454.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,244.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,547.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,547.80
|
| Rate for Payer: Multiplan Commercial |
$7,483.20
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,612.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,612.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Senior |
$7,950.90
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,870.80 |
| Max. Negotiated Rate |
$7,950.90 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Cash Price |
$4,209.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,563.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,244.96
|
| Rate for Payer: Multiplan Commercial |
$7,483.20
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$5,036.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,007.20 |
| Max. Negotiated Rate |
$4,280.60 |
| Rate for Payer: Adventist Health Commercial |
$1,007.20
|
| Rate for Payer: Cash Price |
$2,266.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,014.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,014.40
|
| Rate for Payer: Galaxy Health WC |
$4,280.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,359.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,918.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,117.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.64
|
| Rate for Payer: Multiplan Commercial |
$4,028.80
|
| Rate for Payer: Networks By Design Commercial |
$3,273.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,280.60
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$143.94 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cigna of CA HMO |
$1,256.96
|
| Rate for Payer: Cigna of CA PPO |
$1,453.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,309.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$639.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,571.20
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,276.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,669.40
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,178.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$982.00
|
| Rate for Payer: United Healthcare All Other HMO |
$982.00
|
| Rate for Payer: United Healthcare HMO Rider |
$982.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$982.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$392.80 |
| Max. Negotiated Rate |
$1,669.40 |
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$785.60
|
| Rate for Payer: EPIC Health Plan Senior |
$785.60
|
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,309.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$748.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,215.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Multiplan Commercial |
$1,571.20
|
| Rate for Payer: Networks By Design Commercial |
$1,276.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,669.40
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$6,427.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$6,427.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$864.50
|
| Rate for Payer: United Healthcare All Other HMO |
$864.50
|
| Rate for Payer: United Healthcare HMO Rider |
$864.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$864.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
