|
HC ICD INSERT/REPL + DUAL LEADS
|
Facility
|
IP
|
$95,252.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,050.40 |
| Max. Negotiated Rate |
$80,964.20 |
| Rate for Payer: Adventist Health Commercial |
$19,050.40
|
| Rate for Payer: Cash Price |
$42,863.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66,676.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38,100.80
|
| Rate for Payer: Galaxy Health WC |
$80,964.20
|
| Rate for Payer: Global Benefits Group Commercial |
$57,151.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60,485.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56,198.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,860.48
|
| Rate for Payer: Multiplan Commercial |
$76,201.60
|
| Rate for Payer: Networks By Design Commercial |
$61,913.80
|
| Rate for Payer: Prime Health Services Commercial |
$80,964.20
|
|
|
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 |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$19,050.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,371.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,164.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$42,863.40
|
| Rate for Payer: Cash Price |
$42,863.40
|
| Rate for Payer: Cash Price |
$42,863.40
|
| 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 |
$60,556.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,408.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,371.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66,676.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,612.68
|
| Rate for Payer: EPIC Health Plan Senior |
$44,408.45
|
| 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/Senior |
$66,208.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,503.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,371.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60,485.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,700.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56,519.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,860.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,867.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,097.57
|
| 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 |
$47,626.00
|
| 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 |
$40,371.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Vantage Medical Group Senior |
$40,371.32
|
|
|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
IP
|
$95,252.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,050.40 |
| Max. Negotiated Rate |
$80,964.20 |
| Rate for Payer: Adventist Health Commercial |
$19,050.40
|
| Rate for Payer: Cash Price |
$42,863.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66,676.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38,100.80
|
| Rate for Payer: Galaxy Health WC |
$80,964.20
|
| Rate for Payer: Global Benefits Group Commercial |
$57,151.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60,485.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56,198.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,860.48
|
| Rate for Payer: Multiplan Commercial |
$76,201.60
|
| Rate for Payer: Networks By Design Commercial |
$61,913.80
|
| Rate for Payer: Prime Health Services Commercial |
$80,964.20
|
|
|
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 |
$37,200.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57,866.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52,493.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48,773.53
|
| 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
|
OP
|
$82,667.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$644.85 |
| Max. Negotiated Rate |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$16,533.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,608.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,164.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$37,200.15
|
| Rate for Payer: Cash Price |
$37,200.15
|
| Rate for Payer: Cash Price |
$37,200.15
|
| 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 |
$42,913.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,469.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,608.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57,866.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,204.78
|
| Rate for Payer: EPIC Health Plan Senior |
$31,469.86
|
| 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/Senior |
$46,918.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,608.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52,493.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,052.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,840.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,047.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,336.01
|
| 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 |
$41,333.50
|
| 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 |
$28,608.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28,608.96
|
|
|
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 |
$2,619.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,434.98
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| 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 |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| 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/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| 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 |
$2,911.00
|
| 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 |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
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 |
$1,495.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,326.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,110.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,961.16
|
| 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
|
OP
|
$3,324.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906811383
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$664.80 |
| Max. Negotiated Rate |
$11,924.00 |
| Rate for Payer: Adventist Health Commercial |
$664.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,215.39
|
| 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 |
$11,924.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,495.80
|
| Rate for Payer: Cash Price |
$1,495.80
|
| Rate for Payer: Cash Price |
$1,495.80
|
| Rate for Payer: Cash Price |
$1,495.80
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,326.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,110.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$918.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,961.16
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| 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 |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,035.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,378.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,919.09
|
| 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/Senior |
$4,352.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$123.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,753.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,715.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,343.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,555.98
|
| 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 |
$2,168.00
|
| 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 |
$2,653.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,035.20
|
| 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 |
$2,753.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,558.24
|
| 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 |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$13,948.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,608.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| 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 |
$42,913.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,469.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,608.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48,819.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,204.78
|
| Rate for Payer: EPIC Health Plan Senior |
$31,469.86
|
| 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/Senior |
$46,918.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$526.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,608.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44,286.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$595.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,052.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,738.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,047.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,336.01
|
| 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 |
$34,871.00
|
| 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 |
$28,608.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28,608.96
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$48,819.40
|
| 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 |
$44,286.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41,147.78
|
| 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
|
OP
|
$92,988.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.03 |
| Max. Negotiated Rate |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$18,597.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,371.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,164.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| 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 |
$60,556.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,408.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,371.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65,091.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,612.68
|
| Rate for Payer: EPIC Health Plan Senior |
$44,408.45
|
| 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/Senior |
$66,208.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$546.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,371.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59,047.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$617.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56,519.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,317.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,867.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,097.57
|
| 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 |
$46,494.00
|
| 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 |
$40,371.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Vantage Medical Group Senior |
$40,371.32
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$65,091.60
|
| 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 |
$59,047.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54,862.92
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$45,887.80
|
| 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 |
$41,626.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38,676.86
|
| 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
|
OP
|
$65,554.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$13,110.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,608.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,164.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| 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 |
$42,913.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,469.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,608.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45,887.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,204.78
|
| Rate for Payer: EPIC Health Plan Senior |
$31,469.86
|
| 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/Senior |
$46,918.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,608.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41,626.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40,052.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,732.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,047.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,336.01
|
| 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 |
$32,777.00
|
| 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 |
$28,608.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28,608.96
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,525.20
|
| 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 |
$3,197.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,971.24
|
| 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 ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$5,036.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$358.87 |
| Max. Negotiated Rate |
$7,196.06 |
| Rate for Payer: Adventist Health Commercial |
$1,007.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$358.87
|
| 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 |
$3,231.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$2,266.20
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,525.20
|
| 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: Inland Empire Health Plan (IEHP) Medi-Cal |
$454.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,197.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,971.24
|
| 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 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: EPIC Health Plan Senior |
$785.60
|
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,374.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$785.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,158.76
|
| 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 COMPL OR MULT
|
Facility
|
IP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
456
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,374.80
|
| 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 |
$1,247.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,158.76
|
| 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 COMPL OR MULT
|
Facility
|
OP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Adventist Health Commercial |
$805.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,003.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,374.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| 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: TriValley Medical Group Commercial/Senior |
$1,178.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
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 |
$392.80 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,374.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| 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/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| 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 |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| 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 |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,020.11
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| 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 |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,020.11
|
| 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
|
|
