|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
OP
|
$95,252.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,503.62 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$19,050.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$7,415.66
|
| Rate for Payer: Cash Price |
$52,388.60
|
| Rate for Payer: Cash Price |
$52,388.60
|
| Rate for Payer: Cash Price |
$52,388.60
|
| Rate for Payer: Cigna of CA HMO |
$60,961.28
|
| Rate for Payer: Cigna of CA PPO |
$70,486.48
|
| 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 |
$80,964.20
|
| Rate for Payer: Global Benefits Group Commercial |
$57,151.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,503.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,533.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,700.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,860.48
|
| 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 |
$76,201.60
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$61,913.80
|
| Rate for Payer: Prime Health Services Commercial |
$80,964.20
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57,151.20
|
| 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 |
$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 INSERT SINGLE/DBL CHAMBER
|
Facility
|
OP
|
$80,342.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906820124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$644.85 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$16,068.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$7,415.66
|
| Rate for Payer: Cash Price |
$44,188.10
|
| Rate for Payer: Cash Price |
$44,188.10
|
| Rate for Payer: Cash Price |
$44,188.10
|
| Rate for Payer: Cigna of CA HMO |
$51,418.88
|
| Rate for Payer: Cigna of CA PPO |
$59,453.08
|
| 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 |
$68,290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$48,205.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,588.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,282.08
|
| 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 |
$64,273.60
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$52,222.30
|
| Rate for Payer: Prime Health Services Commercial |
$68,290.70
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48,205.20
|
| 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 INSERT SINGLE/DBL CHAMBER
|
Facility
|
OP
|
$82,667.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$644.85 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$16,533.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$7,415.66
|
| Rate for Payer: Cash Price |
$45,466.85
|
| Rate for Payer: Cash Price |
$45,466.85
|
| Rate for Payer: Cash Price |
$45,466.85
|
| Rate for Payer: Cigna of CA HMO |
$52,906.88
|
| Rate for Payer: Cigna of CA PPO |
$61,173.58
|
| 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 |
$70,266.95
|
| Rate for Payer: Global Benefits Group Commercial |
$49,600.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55,138.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,840.08
|
| 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 |
$66,133.60
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$53,733.55
|
| Rate for Payer: Prime Health Services Commercial |
$70,266.95
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,600.20
|
| 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 INSERT SINGLE/DBL CHAMBER
|
Facility
|
IP
|
$82,667.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,533.40 |
| Max. Negotiated Rate |
$70,266.95 |
| Rate for Payer: Adventist Health Commercial |
$16,533.40
|
| Rate for Payer: Cash Price |
$45,466.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,066.80
|
| Rate for Payer: EPIC Health Plan Senior |
$33,066.80
|
| Rate for Payer: Galaxy Health WC |
$70,266.95
|
| Rate for Payer: Global Benefits Group Commercial |
$49,600.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55,138.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,496.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,170.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,840.08
|
| Rate for Payer: Multiplan Commercial |
$66,133.60
|
| Rate for Payer: Networks By Design Commercial |
$53,733.55
|
| Rate for Payer: Prime Health Services Commercial |
$70,266.95
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
IP
|
$80,342.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906820124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,068.40 |
| Max. Negotiated Rate |
$68,290.70 |
| Rate for Payer: Adventist Health Commercial |
$16,068.40
|
| Rate for Payer: Cash Price |
$44,188.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,136.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32,136.80
|
| Rate for Payer: Galaxy Health WC |
$68,290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$48,205.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,588.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,610.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,731.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,282.08
|
| Rate for Payer: Multiplan Commercial |
$64,273.60
|
| Rate for Payer: Networks By Design Commercial |
$52,222.30
|
| Rate for Payer: Prime Health Services Commercial |
$68,290.70
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906820123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.25 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,822.94
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
IP
|
$5,822.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906811373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,164.40 |
| Max. Negotiated Rate |
$4,948.70 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,218.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,603.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
OP
|
$5,822.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906811373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.25 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,822.94
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906820123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,131.80 |
| Max. Negotiated Rate |
$4,810.15 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
OP
|
$3,324.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906811383
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$664.80 |
| Max. Negotiated Rate |
$11,411.00 |
| Rate for Payer: Adventist Health Commercial |
$664.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,825.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,828.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,493.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,411.00
|
| 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 |
$1,828.20
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Cigna of CA HMO |
$2,127.36
|
| Rate for Payer: Cigna of CA PPO |
$2,459.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,825.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,825.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,825.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,329.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,329.60
|
| Rate for Payer: Galaxy Health WC |
$2,825.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,994.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$812.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,217.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$918.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,057.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$797.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,326.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,326.80
|
| Rate for Payer: Multiplan Commercial |
$2,659.20
|
| Rate for Payer: Networks By Design Commercial |
$2,160.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,825.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,994.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,994.40
|
| 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 |
$2,825.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,825.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,825.40
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
OP
|
$3,910.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906820055
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$11,411.00 |
| Rate for Payer: Adventist Health Commercial |
$782.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,323.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,150.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,932.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,411.00
|
| 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 |
$2,150.50
|
| Rate for Payer: Cash Price |
$2,150.50
|
| Rate for Payer: Cash Price |
$2,150.50
|
| Rate for Payer: Cigna of CA HMO |
$2,502.40
|
| Rate for Payer: Cigna of CA PPO |
$2,893.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,323.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,323.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,323.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,564.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,564.00
|
| Rate for Payer: Galaxy Health WC |
$3,323.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,346.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$812.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,607.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$918.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,420.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$938.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,737.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,737.00
|
| Rate for Payer: Multiplan Commercial |
$3,128.00
|
| Rate for Payer: Networks By Design Commercial |
$2,541.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,323.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,346.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,346.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$3,323.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,323.50
|
| Rate for Payer: Vantage Medical Group Senior |
$3,323.50
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
IP
|
$3,324.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906811383
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$664.80 |
| Max. Negotiated Rate |
$2,825.40 |
| Rate for Payer: Adventist Health Commercial |
$664.80
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,329.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,329.60
|
| Rate for Payer: Galaxy Health WC |
$2,825.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,994.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,217.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,266.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,057.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$797.76
|
| Rate for Payer: Multiplan Commercial |
$2,659.20
|
| Rate for Payer: Networks By Design Commercial |
$2,160.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,825.40
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
IP
|
$3,910.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906820055
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$782.00 |
| Max. Negotiated Rate |
$3,323.50 |
| Rate for Payer: Adventist Health Commercial |
$782.00
|
| Rate for Payer: Cash Price |
$2,150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,564.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,564.00
|
| Rate for Payer: Galaxy Health WC |
$3,323.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,346.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,607.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,489.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,420.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$938.40
|
| Rate for Payer: Multiplan Commercial |
$3,128.00
|
| Rate for Payer: Networks By Design Commercial |
$2,541.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,323.50
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
OP
|
$4,336.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.85 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| 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 |
$2,384.80
|
| Rate for Payer: Cash Price |
$2,384.80
|
| Rate for Payer: Cash Price |
$2,384.80
|
| Rate for Payer: Cigna of CA HMO |
$2,775.04
|
| Rate for Payer: Cigna of CA PPO |
$3,208.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$3,685.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,601.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$123.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,892.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$3,468.80
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,818.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,685.60
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,601.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
IP
|
$4,214.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906820106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$842.80 |
| Max. Negotiated Rate |
$3,581.90 |
| Rate for Payer: Adventist Health Commercial |
$842.80
|
| Rate for Payer: Cash Price |
$2,317.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,685.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,685.60
|
| Rate for Payer: Galaxy Health WC |
$3,581.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,528.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,810.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,605.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,608.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,011.36
|
| Rate for Payer: Multiplan Commercial |
$3,371.20
|
| Rate for Payer: Networks By Design Commercial |
$2,739.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,581.90
|
|
|
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 |
$2,384.80
|
| 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 Permanente of CA Commercial/Self Funded |
$2,892.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,652.02
|
| Rate for Payer: Kaiser Permanente of CA 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 POCKET REVISION/RELOC
|
Facility
|
OP
|
$4,214.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906820106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.85 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$842.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| 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 |
$2,317.70
|
| Rate for Payer: Cash Price |
$2,317.70
|
| Rate for Payer: Cash Price |
$2,317.70
|
| Rate for Payer: Cigna of CA HMO |
$2,696.96
|
| Rate for Payer: Cigna of CA PPO |
$3,118.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$3,581.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,528.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$123.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,810.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,011.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$3,371.20
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,739.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,581.90
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,528.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
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 |
$38,358.10
|
| 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 Permanente of CA Commercial/Self Funded |
$46,517.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26,571.70
|
| Rate for Payer: Kaiser Permanente of CA 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 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 |
$37,279.00
|
| 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 Permanente of CA Commercial/Self Funded |
$45,209.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,824.18
|
| Rate for Payer: Kaiser Permanente of CA 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 |
$37,279.00
|
| Rate for Payer: Cash Price |
$37,279.00
|
| Rate for Payer: Cash Price |
$37,279.00
|
| 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 Permanente of CA Commercial/Self Funded |
$45,209.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$595.61
|
| Rate for Payer: Kaiser Permanente of CA 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
|
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 |
$38,358.10
|
| Rate for Payer: Cash Price |
$38,358.10
|
| Rate for Payer: Cash Price |
$38,358.10
|
| 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 Permanente of CA Commercial/Self Funded |
$46,517.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$595.61
|
| Rate for Payer: Kaiser Permanente of CA 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 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 |
$51,143.40
|
| Rate for Payer: Cash Price |
$51,143.40
|
| Rate for Payer: Cash Price |
$51,143.40
|
| 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 Permanente of CA Commercial/Self Funded |
$62,023.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.54
|
| Rate for Payer: Kaiser Permanente of CA 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 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 |
$49,705.15
|
| Rate for Payer: Cash Price |
$49,705.15
|
| Rate for Payer: Cash Price |
$49,705.15
|
| 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 Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.54
|
| Rate for Payer: Kaiser Permanente of CA 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
|
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 |
$51,143.40
|
| 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 Permanente of CA Commercial/Self Funded |
$62,023.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35,428.43
|
| Rate for Payer: Kaiser Permanente of CA 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 |
$49,705.15
|
| 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 Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,432.11
|
| Rate for Payer: Kaiser Permanente of CA 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
|
|
