|
HC LEAD B/S RELIANCE GORE DF4 296
|
Facility
|
IP
|
$10,750.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
906813679
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,150.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,837.50
|
| Rate for Payer: Cash Price |
$4,837.50
|
| Rate for Payer: Cigna of CA HMO |
$7,525.00
|
| Rate for Payer: Cigna of CA PPO |
$7,525.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,300.00
|
| Rate for Payer: Galaxy Health WC |
$9,137.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,170.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,095.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,654.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,580.00
|
| Rate for Payer: Multiplan Commercial |
$8,600.00
|
| Rate for Payer: Networks By Design Commercial |
$5,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,137.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,034.47
|
| Rate for Payer: United Healthcare All Other HMO |
$3,926.97
|
| Rate for Payer: United Healthcare HMO Rider |
$3,842.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,520.62
|
|
|
HC LEAD B/S RELIANCE GORE DF4 296
|
Facility
|
OP
|
$10,750.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
906813679
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,150.00 |
| Max. Negotiated Rate |
$9,137.50 |
| Rate for Payer: Adventist Health Commercial |
$2,150.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,137.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,912.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,062.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,601.57
|
| Rate for Payer: Blue Shield of California Commercial |
$7,933.50
|
| Rate for Payer: Blue Shield of California EPN |
$5,224.50
|
| Rate for Payer: Cash Price |
$4,837.50
|
| Rate for Payer: Cigna of CA HMO |
$7,525.00
|
| Rate for Payer: Cigna of CA PPO |
$7,525.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,137.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,137.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,137.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,300.00
|
| Rate for Payer: Galaxy Health WC |
$9,137.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,170.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,654.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,580.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,525.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,525.00
|
| Rate for Payer: Multiplan Commercial |
$8,600.00
|
| Rate for Payer: Networks By Design Commercial |
$5,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,137.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,450.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,450.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,034.47
|
| Rate for Payer: United Healthcare All Other HMO |
$3,926.97
|
| Rate for Payer: United Healthcare HMO Rider |
$3,842.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,520.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,137.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,137.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,137.50
|
|
|
HC LEAD B/S RELIANCE GORE DR4 266
|
Facility
|
IP
|
$10,000.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813684
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,000.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,000.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,500.00
|
| Rate for Payer: Cash Price |
$4,500.00
|
| Rate for Payer: Cigna of CA HMO |
$7,000.00
|
| Rate for Payer: Cigna of CA PPO |
$7,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,000.00
|
| Rate for Payer: Galaxy Health WC |
$8,500.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,000.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,670.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,810.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,190.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,400.00
|
| Rate for Payer: Multiplan Commercial |
$8,000.00
|
| Rate for Payer: Networks By Design Commercial |
$5,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,753.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,653.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,275.00
|
|
|
HC LEAD B/S RELIANCE GORE DR4 266
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813684
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,000.00 |
| Max. Negotiated Rate |
$8,500.00 |
| Rate for Payer: Adventist Health Commercial |
$2,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,500.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,500.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,500.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,141.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,380.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,860.00
|
| Rate for Payer: Cash Price |
$4,500.00
|
| Rate for Payer: Cigna of CA HMO |
$7,000.00
|
| Rate for Payer: Cigna of CA PPO |
$7,000.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,500.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,500.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,000.00
|
| Rate for Payer: Galaxy Health WC |
$8,500.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,000.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,670.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,190.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,400.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,000.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,000.00
|
| Rate for Payer: Multiplan Commercial |
$8,000.00
|
| Rate for Payer: Networks By Design Commercial |
$5,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,500.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,753.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,653.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,275.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,500.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,500.00
|
| Rate for Payer: Vantage Medical Group Senior |
$8,500.00
|
|
|
HC LEAD DELIVERY SYS B/S DSYS
|
Facility
|
IP
|
$2,535.00
|
|
| Hospital Charge Code |
906813545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,690.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,569.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$608.40
|
| Rate for Payer: Multiplan Commercial |
$2,028.00
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
|
|
HC LEAD DELIVERY SYS B/S DSYS
|
Facility
|
OP
|
$2,535.00
|
|
| Hospital Charge Code |
906813545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$2,154.75 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,394.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,901.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,468.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1,870.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,232.01
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,154.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,154.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,690.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,569.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$608.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,774.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,774.50
|
| Rate for Payer: Multiplan Commercial |
$2,028.00
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,521.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,154.75
|
|
|
HC LEAD INGEVITY 7741
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,697.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,117.80
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC LEAD INGEVITY 7741
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$52,096.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,419.20 |
| Max. Negotiated Rate |
$44,281.60 |
| Rate for Payer: Adventist Health Commercial |
$10,419.20
|
| Rate for Payer: Cash Price |
$23,443.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,838.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20,838.40
|
| Rate for Payer: Galaxy Health WC |
$44,281.60
|
| Rate for Payer: Global Benefits Group Commercial |
$31,257.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,748.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,848.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,247.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,503.04
|
| Rate for Payer: Multiplan Commercial |
$41,676.80
|
| Rate for Payer: Networks By Design Commercial |
$33,862.40
|
| Rate for Payer: Prime Health Services Commercial |
$44,281.60
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$53,604.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$469.73 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$10,720.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,922.00
|
| 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 |
$24,121.80
|
| Rate for Payer: Cash Price |
$24,121.80
|
| Rate for Payer: Cash Price |
$24,121.80
|
| Rate for Payer: Cigna of CA HMO |
$34,306.56
|
| Rate for Payer: Cigna of CA PPO |
$39,666.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$45,563.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,162.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$469.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,753.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$42,883.20
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$34,842.60
|
| Rate for Payer: Prime Health Services Commercial |
$45,563.40
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,162.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$52,096.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$469.73 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$10,419.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,922.00
|
| 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 |
$23,443.20
|
| Rate for Payer: Cash Price |
$23,443.20
|
| Rate for Payer: Cash Price |
$23,443.20
|
| Rate for Payer: Cigna of CA HMO |
$33,341.44
|
| Rate for Payer: Cigna of CA PPO |
$38,551.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$44,281.60
|
| Rate for Payer: Global Benefits Group Commercial |
$31,257.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$469.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,748.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,503.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$41,676.80
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$33,862.40
|
| Rate for Payer: Prime Health Services Commercial |
$44,281.60
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,257.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$53,604.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,720.80 |
| Max. Negotiated Rate |
$45,563.40 |
| Rate for Payer: Adventist Health Commercial |
$10,720.80
|
| Rate for Payer: Cash Price |
$24,121.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,441.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21,441.60
|
| Rate for Payer: Galaxy Health WC |
$45,563.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,162.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,753.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,423.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,180.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.96
|
| Rate for Payer: Multiplan Commercial |
$42,883.20
|
| Rate for Payer: Networks By Design Commercial |
$34,842.60
|
| Rate for Payer: Prime Health Services Commercial |
$45,563.40
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$46,956.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,391.20 |
| Max. Negotiated Rate |
$39,912.60 |
| Rate for Payer: Adventist Health Commercial |
$9,391.20
|
| Rate for Payer: Cash Price |
$21,130.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,782.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18,782.40
|
| Rate for Payer: Galaxy Health WC |
$39,912.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,173.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,319.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,890.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,065.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,269.44
|
| Rate for Payer: Multiplan Commercial |
$37,564.80
|
| Rate for Payer: Networks By Design Commercial |
$30,521.40
|
| Rate for Payer: Prime Health Services Commercial |
$39,912.60
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$46,956.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$434.08 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$9,391.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39,912.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,825.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35,217.00
|
| 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 |
$21,130.20
|
| Rate for Payer: Cash Price |
$21,130.20
|
| Rate for Payer: Cash Price |
$21,130.20
|
| Rate for Payer: Cigna of CA HMO |
$30,051.84
|
| Rate for Payer: Cigna of CA PPO |
$34,747.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39,912.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$39,912.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39,912.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,782.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18,782.40
|
| Rate for Payer: Galaxy Health WC |
$39,912.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,173.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$434.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,319.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,065.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,269.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,869.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,869.20
|
| Rate for Payer: Multiplan Commercial |
$37,564.80
|
| Rate for Payer: Networks By Design Commercial |
$30,521.40
|
| Rate for Payer: Prime Health Services Commercial |
$39,912.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,173.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39,912.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39,912.60
|
| Rate for Payer: Vantage Medical Group Senior |
$39,912.60
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$48,315.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$434.08 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$9,663.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41,067.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,573.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,236.25
|
| 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 |
$21,741.75
|
| Rate for Payer: Cash Price |
$21,741.75
|
| Rate for Payer: Cash Price |
$21,741.75
|
| Rate for Payer: Cigna of CA HMO |
$30,921.60
|
| Rate for Payer: Cigna of CA PPO |
$35,753.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41,067.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$41,067.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41,067.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$19,326.00
|
| Rate for Payer: Galaxy Health WC |
$41,067.75
|
| Rate for Payer: Global Benefits Group Commercial |
$28,989.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$434.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,226.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,906.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,595.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,820.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,820.50
|
| Rate for Payer: Multiplan Commercial |
$38,652.00
|
| Rate for Payer: Networks By Design Commercial |
$31,404.75
|
| Rate for Payer: Prime Health Services Commercial |
$41,067.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41,067.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41,067.75
|
| Rate for Payer: Vantage Medical Group Senior |
$41,067.75
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$48,315.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,663.00 |
| Max. Negotiated Rate |
$41,067.75 |
| Rate for Payer: Adventist Health Commercial |
$9,663.00
|
| Rate for Payer: Cash Price |
$21,741.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$19,326.00
|
| Rate for Payer: Galaxy Health WC |
$41,067.75
|
| Rate for Payer: Global Benefits Group Commercial |
$28,989.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,226.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,408.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,906.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,595.60
|
| Rate for Payer: Multiplan Commercial |
$38,652.00
|
| Rate for Payer: Networks By Design Commercial |
$31,404.75
|
| Rate for Payer: Prime Health Services Commercial |
$41,067.75
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$16,355.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,271.00 |
| Max. Negotiated Rate |
$13,901.75 |
| Rate for Payer: Adventist Health Commercial |
$3,271.00
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,542.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,542.00
|
| Rate for Payer: Galaxy Health WC |
$13,901.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,813.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,908.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,231.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,123.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,925.20
|
| Rate for Payer: Multiplan Commercial |
$13,084.00
|
| Rate for Payer: Networks By Design Commercial |
$10,630.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,901.75
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$15,895.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.71 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| 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 |
$7,152.75
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: Cigna of CA HMO |
$10,172.80
|
| Rate for Payer: Cigna of CA PPO |
$11,762.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$13,510.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,537.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$105.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,601.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,814.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$12,716.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$10,331.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,510.75
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,537.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$16,355.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.71 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,271.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| 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 |
$7,359.75
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: Cigna of CA HMO |
$10,467.20
|
| Rate for Payer: Cigna of CA PPO |
$12,102.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$13,901.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,813.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$105.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,908.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,925.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$13,084.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$10,630.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,901.75
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,813.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$15,895.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,179.00 |
| Max. Negotiated Rate |
$13,510.75 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,358.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,358.00
|
| Rate for Payer: Galaxy Health WC |
$13,510.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,537.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,601.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,055.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,839.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,814.80
|
| Rate for Payer: Multiplan Commercial |
$12,716.00
|
| Rate for Payer: Networks By Design Commercial |
$10,331.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,510.75
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$16,355.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$750.56 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,271.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| 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 |
$7,359.75
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: Cigna of CA HMO |
$10,467.20
|
| Rate for Payer: Cigna of CA PPO |
$12,102.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$13,901.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,813.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$750.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,908.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,925.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$13,084.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$10,630.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,901.75
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,813.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$15,895.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,179.00 |
| Max. Negotiated Rate |
$13,510.75 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,358.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,358.00
|
| Rate for Payer: Galaxy Health WC |
$13,510.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,537.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,601.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,055.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,839.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,814.80
|
| Rate for Payer: Multiplan Commercial |
$12,716.00
|
| Rate for Payer: Networks By Design Commercial |
$10,331.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,510.75
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$15,895.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$750.56 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| 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 |
$7,152.75
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: Cash Price |
$7,152.75
|
| Rate for Payer: Cigna of CA HMO |
$10,172.80
|
| Rate for Payer: Cigna of CA PPO |
$11,762.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$13,510.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,537.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$750.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,601.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,814.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$12,716.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$10,331.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,510.75
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,537.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$16,355.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,271.00 |
| Max. Negotiated Rate |
$13,901.75 |
| Rate for Payer: Adventist Health Commercial |
$3,271.00
|
| Rate for Payer: Cash Price |
$7,359.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,542.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,542.00
|
| Rate for Payer: Galaxy Health WC |
$13,901.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,813.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,908.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,231.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,123.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,925.20
|
| Rate for Payer: Multiplan Commercial |
$13,084.00
|
| Rate for Payer: Networks By Design Commercial |
$10,630.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,901.75
|
|
|
HC LEAD MED ATTAIN 4396
|
Facility
|
OP
|
$6,750.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813659
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$5,737.50 |
| Rate for Payer: Adventist Health Commercial |
$1,350.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,737.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,712.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,062.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,145.18
|
| Rate for Payer: Blue Shield of California Commercial |
$4,981.50
|
| Rate for Payer: Blue Shield of California EPN |
$3,280.50
|
| Rate for Payer: Cash Price |
$3,037.50
|
| Rate for Payer: Cigna of CA HMO |
$4,725.00
|
| Rate for Payer: Cigna of CA PPO |
$4,725.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,737.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,737.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,737.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,700.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,700.00
|
| Rate for Payer: Galaxy Health WC |
$5,737.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,050.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,502.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,571.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,178.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,620.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,725.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,725.00
|
| Rate for Payer: Multiplan Commercial |
$5,400.00
|
| Rate for Payer: Networks By Design Commercial |
$3,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,737.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,050.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,050.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,533.28
|
| Rate for Payer: United Healthcare All Other HMO |
$2,465.78
|
| Rate for Payer: United Healthcare HMO Rider |
$2,412.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,210.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,737.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,737.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5,737.50
|
|
