|
HC PACE BIO ELUNA PROMRI 394969
|
Facility
|
OP
|
$12,250.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813747
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,450.00 |
| Max. Negotiated Rate |
$10,412.50 |
| Rate for Payer: Adventist Health Commercial |
$2,450.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,412.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,737.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,187.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,522.73
|
| Rate for Payer: Blue Shield of California Commercial |
$9,040.50
|
| Rate for Payer: Blue Shield of California EPN |
$5,953.50
|
| Rate for Payer: Cash Price |
$6,737.50
|
| Rate for Payer: Cigna of CA HMO |
$8,575.00
|
| Rate for Payer: Cigna of CA PPO |
$8,575.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,412.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,412.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,900.00
|
| Rate for Payer: Galaxy Health WC |
$10,412.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,350.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,170.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,582.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,940.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,575.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,575.00
|
| Rate for Payer: Multiplan Commercial |
$9,800.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,412.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,350.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,350.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,597.43
|
| Rate for Payer: United Healthcare All Other HMO |
$4,474.93
|
| Rate for Payer: United Healthcare HMO Rider |
$4,378.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,011.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,412.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,412.50
|
| Rate for Payer: Vantage Medical Group Senior |
$10,412.50
|
|
|
HC PACE BIO ELUNA PROMRI 394969
|
Facility
|
IP
|
$12,250.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813747
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,450.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,450.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$6,737.50
|
| Rate for Payer: Cash Price |
$6,737.50
|
| Rate for Payer: Cigna of CA HMO |
$8,575.00
|
| Rate for Payer: Cigna of CA PPO |
$8,575.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,900.00
|
| Rate for Payer: Galaxy Health WC |
$10,412.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,350.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,170.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,667.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,582.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,940.00
|
| Rate for Payer: Multiplan Commercial |
$9,800.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,412.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,597.43
|
| Rate for Payer: United Healthcare All Other HMO |
$4,474.93
|
| Rate for Payer: United Healthcare HMO Rider |
$4,378.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,011.88
|
|
|
HC PACE BIOTRONIK EDORA 8 407145
|
Facility
|
OP
|
$13,250.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813797
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,650.00 |
| Max. Negotiated Rate |
$11,262.50 |
| Rate for Payer: Adventist Health Commercial |
$2,650.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,262.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,287.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,937.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,136.82
|
| Rate for Payer: Blue Shield of California Commercial |
$9,778.50
|
| Rate for Payer: Blue Shield of California EPN |
$6,439.50
|
| Rate for Payer: Cash Price |
$7,287.50
|
| Rate for Payer: Cigna of CA HMO |
$9,275.00
|
| Rate for Payer: Cigna of CA PPO |
$9,275.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,262.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,262.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,262.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,300.00
|
| Rate for Payer: Galaxy Health WC |
$11,262.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,837.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,201.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,180.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,275.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,275.00
|
| Rate for Payer: Multiplan Commercial |
$10,600.00
|
| Rate for Payer: Networks By Design Commercial |
$6,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$11,262.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,950.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,950.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,972.73
|
| Rate for Payer: United Healthcare All Other HMO |
$4,840.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4,735.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,339.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,262.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,262.50
|
| Rate for Payer: Vantage Medical Group Senior |
$11,262.50
|
|
|
HC PACE BIOTRONIK EDORA 8 407145
|
Facility
|
IP
|
$13,250.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813797
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,650.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,650.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$7,287.50
|
| Rate for Payer: Cash Price |
$7,287.50
|
| Rate for Payer: Cigna of CA HMO |
$9,275.00
|
| Rate for Payer: Cigna of CA PPO |
$9,275.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,300.00
|
| Rate for Payer: Galaxy Health WC |
$11,262.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,837.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,048.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,201.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,180.00
|
| Rate for Payer: Multiplan Commercial |
$10,600.00
|
| Rate for Payer: Networks By Design Commercial |
$6,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$11,262.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,972.73
|
| Rate for Payer: United Healthcare All Other HMO |
$4,840.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4,735.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,339.38
|
|
|
HC PACE BIOTRONIK EDORA 8 407147
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813816
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,900.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cigna of CA HMO |
$6,650.00
|
| Rate for Payer: Cigna of CA PPO |
$6,650.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,800.00
|
| Rate for Payer: Galaxy Health WC |
$8,075.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,336.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,619.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,880.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Multiplan Commercial |
$7,600.00
|
| Rate for Payer: Networks By Design Commercial |
$4,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,075.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,565.35
|
| Rate for Payer: United Healthcare All Other HMO |
$3,470.35
|
| Rate for Payer: United Healthcare HMO Rider |
$3,395.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,111.25
|
|
|
HC PACE BIOTRONIK EDORA 8 407147
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813816
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,900.00 |
| Max. Negotiated Rate |
$8,075.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,225.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,125.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,833.95
|
| Rate for Payer: Blue Shield of California Commercial |
$7,011.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,617.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cigna of CA HMO |
$6,650.00
|
| Rate for Payer: Cigna of CA PPO |
$6,650.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,075.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,075.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,800.00
|
| Rate for Payer: Galaxy Health WC |
$8,075.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,336.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,880.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,650.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,650.00
|
| Rate for Payer: Multiplan Commercial |
$7,600.00
|
| Rate for Payer: Networks By Design Commercial |
$4,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,075.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,700.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,700.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,565.35
|
| Rate for Payer: United Healthcare All Other HMO |
$3,470.35
|
| Rate for Payer: United Healthcare HMO Rider |
$3,395.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,111.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Senior |
$8,075.00
|
|
|
HC PACE BIOTRONIK ELUNA 8 394971
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813790
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,750.00 |
| Max. Negotiated Rate |
$7,437.50 |
| Rate for Payer: Adventist Health Commercial |
$1,750.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,437.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,812.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,562.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,373.38
|
| Rate for Payer: Blue Shield of California Commercial |
$6,457.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,252.50
|
| Rate for Payer: Cash Price |
$4,812.50
|
| Rate for Payer: Cigna of CA HMO |
$6,125.00
|
| Rate for Payer: Cigna of CA PPO |
$6,125.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,437.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,437.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,437.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,500.00
|
| Rate for Payer: Galaxy Health WC |
$7,437.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,250.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,836.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,416.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,100.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,125.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,125.00
|
| Rate for Payer: Multiplan Commercial |
$7,000.00
|
| Rate for Payer: Networks By Design Commercial |
$4,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,437.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,250.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,283.88
|
| Rate for Payer: United Healthcare All Other HMO |
$3,196.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,127.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,865.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,437.50
|
| Rate for Payer: Vantage Medical Group Senior |
$7,437.50
|
|
|
HC PACE BIOTRONIK ELUNA 8 394971
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813790
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,750.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,750.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,812.50
|
| Rate for Payer: Cash Price |
$4,812.50
|
| Rate for Payer: Cigna of CA HMO |
$6,125.00
|
| Rate for Payer: Cigna of CA PPO |
$6,125.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,500.00
|
| Rate for Payer: Galaxy Health WC |
$7,437.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,250.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,836.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,333.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,416.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,100.00
|
| Rate for Payer: Multiplan Commercial |
$7,000.00
|
| Rate for Payer: Networks By Design Commercial |
$4,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,437.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,283.88
|
| Rate for Payer: United Healthcare All Other HMO |
$3,196.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,127.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,865.62
|
|
|
HC PACE BIOTRONIK ETRINSA 394919
|
Facility
|
OP
|
$15,750.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813811
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,150.00 |
| Max. Negotiated Rate |
$13,387.50 |
| Rate for Payer: Adventist Health Commercial |
$3,150.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,387.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,662.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,812.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,672.08
|
| Rate for Payer: Blue Shield of California Commercial |
$11,623.50
|
| Rate for Payer: Blue Shield of California EPN |
$7,654.50
|
| Rate for Payer: Cash Price |
$8,662.50
|
| Rate for Payer: Cigna of CA HMO |
$11,025.00
|
| Rate for Payer: Cigna of CA PPO |
$11,025.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,387.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,387.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,387.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,300.00
|
| Rate for Payer: Galaxy Health WC |
$13,387.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,505.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,749.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,025.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,025.00
|
| Rate for Payer: Multiplan Commercial |
$12,600.00
|
| Rate for Payer: Networks By Design Commercial |
$7,875.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,387.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,450.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,450.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,910.98
|
| Rate for Payer: United Healthcare All Other HMO |
$5,753.48
|
| Rate for Payer: United Healthcare HMO Rider |
$5,629.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,158.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,387.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,387.50
|
| Rate for Payer: Vantage Medical Group Senior |
$13,387.50
|
|
|
HC PACE BIOTRONIK ETRINSA 394919
|
Facility
|
IP
|
$15,750.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813811
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,150.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$3,150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$8,662.50
|
| Rate for Payer: Cash Price |
$8,662.50
|
| Rate for Payer: Cigna of CA HMO |
$11,025.00
|
| Rate for Payer: Cigna of CA PPO |
$11,025.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,300.00
|
| Rate for Payer: Galaxy Health WC |
$13,387.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,505.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,000.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,749.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,780.00
|
| Rate for Payer: Multiplan Commercial |
$12,600.00
|
| Rate for Payer: Networks By Design Commercial |
$7,875.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,387.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,910.98
|
| Rate for Payer: United Healthcare All Other HMO |
$5,753.48
|
| Rate for Payer: United Healthcare HMO Rider |
$5,629.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,158.12
|
|
|
HC PACE BIOTRONIK EVIA DR 359529
|
Facility
|
OP
|
$12,400.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813719
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,480.00 |
| Max. Negotiated Rate |
$10,540.00 |
| Rate for Payer: Adventist Health Commercial |
$2,480.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,540.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,820.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,614.84
|
| Rate for Payer: Blue Shield of California Commercial |
$9,151.20
|
| Rate for Payer: Blue Shield of California EPN |
$6,026.40
|
| Rate for Payer: Cash Price |
$6,820.00
|
| Rate for Payer: Cigna of CA HMO |
$8,680.00
|
| Rate for Payer: Cigna of CA PPO |
$8,680.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,540.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,540.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,960.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,960.00
|
| Rate for Payer: Galaxy Health WC |
$10,540.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,440.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,270.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,675.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,976.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,680.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,680.00
|
| Rate for Payer: Multiplan Commercial |
$9,920.00
|
| Rate for Payer: Networks By Design Commercial |
$6,200.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,540.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,440.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,440.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,653.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4,529.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4,431.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,540.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,540.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,540.00
|
|
|
HC PACE BIOTRONIK EVIA DR 359529
|
Facility
|
IP
|
$12,400.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813719
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,480.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,480.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$6,820.00
|
| Rate for Payer: Cash Price |
$6,820.00
|
| Rate for Payer: Cigna of CA HMO |
$8,680.00
|
| Rate for Payer: Cigna of CA PPO |
$8,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,960.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,960.00
|
| Rate for Payer: Galaxy Health WC |
$10,540.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,440.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,724.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,675.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,976.00
|
| Rate for Payer: Multiplan Commercial |
$9,920.00
|
| Rate for Payer: Networks By Design Commercial |
$6,200.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,540.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,653.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4,529.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4,431.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,061.00
|
|
|
HC PACE B/S ACCOLADE DR L301
|
Facility
|
OP
|
$10,325.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813794
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,065.00 |
| Max. Negotiated Rate |
$8,776.25 |
| Rate for Payer: Adventist Health Commercial |
$2,065.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,678.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,743.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,340.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7,619.85
|
| Rate for Payer: Blue Shield of California EPN |
$5,017.95
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cigna of CA HMO |
$7,227.50
|
| Rate for Payer: Cigna of CA PPO |
$7,227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,776.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,776.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,130.00
|
| Rate for Payer: Galaxy Health WC |
$8,776.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,195.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,886.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,391.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,478.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,227.50
|
| Rate for Payer: Multiplan Commercial |
$8,260.00
|
| Rate for Payer: Networks By Design Commercial |
$5,162.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,776.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,874.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3,771.72
|
| Rate for Payer: United Healthcare HMO Rider |
$3,690.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,381.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,776.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8,776.25
|
|
|
HC PACE B/S ACCOLADE DR L301
|
Facility
|
IP
|
$10,325.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813794
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,065.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,065.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cigna of CA HMO |
$7,227.50
|
| Rate for Payer: Cigna of CA PPO |
$7,227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,130.00
|
| Rate for Payer: Galaxy Health WC |
$8,776.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,195.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,886.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,933.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,391.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,478.00
|
| Rate for Payer: Multiplan Commercial |
$8,260.00
|
| Rate for Payer: Networks By Design Commercial |
$5,162.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,776.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,874.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3,771.72
|
| Rate for Payer: United Healthcare HMO Rider |
$3,690.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,381.44
|
|
|
HC PACE B/S ACCOLADE DR MRI L311
|
Facility
|
OP
|
$12,200.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813767
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,440.00 |
| Max. Negotiated Rate |
$10,370.00 |
| Rate for Payer: Adventist Health Commercial |
$2,440.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,370.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,710.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,492.02
|
| Rate for Payer: Blue Shield of California Commercial |
$9,003.60
|
| Rate for Payer: Blue Shield of California EPN |
$5,929.20
|
| Rate for Payer: Cash Price |
$6,710.00
|
| Rate for Payer: Cigna of CA HMO |
$8,540.00
|
| Rate for Payer: Cigna of CA PPO |
$8,540.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,370.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,370.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,370.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,880.00
|
| Rate for Payer: Galaxy Health WC |
$10,370.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,320.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,137.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,551.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,928.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,540.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,540.00
|
| Rate for Payer: Multiplan Commercial |
$9,760.00
|
| Rate for Payer: Networks By Design Commercial |
$6,100.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,370.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,320.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,320.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,578.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4,456.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4,360.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,995.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,370.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,370.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,370.00
|
|
|
HC PACE B/S ACCOLADE DR MRI L311
|
Facility
|
IP
|
$12,200.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813767
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,440.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,440.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$6,710.00
|
| Rate for Payer: Cash Price |
$6,710.00
|
| Rate for Payer: Cigna of CA HMO |
$8,540.00
|
| Rate for Payer: Cigna of CA PPO |
$8,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,880.00
|
| Rate for Payer: Galaxy Health WC |
$10,370.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,320.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,137.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,648.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,551.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,928.00
|
| Rate for Payer: Multiplan Commercial |
$9,760.00
|
| Rate for Payer: Networks By Design Commercial |
$6,100.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,370.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,578.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4,456.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4,360.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,995.50
|
|
|
HC PACE BS ACCOLADE EL DR L321
|
Facility
|
IP
|
$10,825.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813743
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,165.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,165.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,953.75
|
| Rate for Payer: Cash Price |
$5,953.75
|
| Rate for Payer: Cigna of CA HMO |
$7,577.50
|
| Rate for Payer: Cigna of CA PPO |
$7,577.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,330.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,330.00
|
| Rate for Payer: Galaxy Health WC |
$9,201.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,495.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,220.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,124.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,700.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,598.00
|
| Rate for Payer: Multiplan Commercial |
$8,660.00
|
| Rate for Payer: Networks By Design Commercial |
$5,412.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,201.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,062.62
|
| Rate for Payer: United Healthcare All Other HMO |
$3,954.37
|
| Rate for Payer: United Healthcare HMO Rider |
$3,868.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,545.19
|
|
|
HC PACE BS ACCOLADE EL DR L321
|
Facility
|
OP
|
$10,825.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813743
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,165.00 |
| Max. Negotiated Rate |
$9,201.25 |
| Rate for Payer: Adventist Health Commercial |
$2,165.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,201.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,953.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,118.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,647.63
|
| Rate for Payer: Blue Shield of California Commercial |
$7,988.85
|
| Rate for Payer: Blue Shield of California EPN |
$5,260.95
|
| Rate for Payer: Cash Price |
$5,953.75
|
| Rate for Payer: Cigna of CA HMO |
$7,577.50
|
| Rate for Payer: Cigna of CA PPO |
$7,577.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,201.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,201.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,201.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,330.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,330.00
|
| Rate for Payer: Galaxy Health WC |
$9,201.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,495.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,220.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,700.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,598.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,577.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,577.50
|
| Rate for Payer: Multiplan Commercial |
$8,660.00
|
| Rate for Payer: Networks By Design Commercial |
$5,412.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,201.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,495.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,495.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,062.62
|
| Rate for Payer: United Healthcare All Other HMO |
$3,954.37
|
| Rate for Payer: United Healthcare HMO Rider |
$3,868.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,545.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,201.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,201.25
|
| Rate for Payer: Vantage Medical Group Senior |
$9,201.25
|
|
|
HC PACE B/S ACCOLADE EL MRI L331
|
Facility
|
IP
|
$12,700.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813766
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,540.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,540.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$6,985.00
|
| Rate for Payer: Cash Price |
$6,985.00
|
| Rate for Payer: Cigna of CA HMO |
$8,890.00
|
| Rate for Payer: Cigna of CA PPO |
$8,890.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,080.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,080.00
|
| Rate for Payer: Galaxy Health WC |
$10,795.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,620.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,470.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,838.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,861.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,048.00
|
| Rate for Payer: Multiplan Commercial |
$10,160.00
|
| Rate for Payer: Networks By Design Commercial |
$6,350.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,795.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,766.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4,639.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4,538.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,159.25
|
|
|
HC PACE B/S ACCOLADE EL MRI L331
|
Facility
|
OP
|
$12,700.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813766
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,540.00 |
| Max. Negotiated Rate |
$10,795.00 |
| Rate for Payer: Adventist Health Commercial |
$2,540.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,795.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,985.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,525.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,799.07
|
| Rate for Payer: Blue Shield of California Commercial |
$9,372.60
|
| Rate for Payer: Blue Shield of California EPN |
$6,172.20
|
| Rate for Payer: Cash Price |
$6,985.00
|
| Rate for Payer: Cigna of CA HMO |
$8,890.00
|
| Rate for Payer: Cigna of CA PPO |
$8,890.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,795.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,795.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,795.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,080.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,080.00
|
| Rate for Payer: Galaxy Health WC |
$10,795.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,620.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,470.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,861.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,048.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,890.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,890.00
|
| Rate for Payer: Multiplan Commercial |
$10,160.00
|
| Rate for Payer: Networks By Design Commercial |
$6,350.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,795.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,620.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,620.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,766.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4,639.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4,538.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,159.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,795.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,795.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,795.00
|
|
|
HC PACE B/S ACCOLADE SR L300
|
Facility
|
OP
|
$9,250.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813783
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,850.00 |
| Max. Negotiated Rate |
$7,862.50 |
| Rate for Payer: Adventist Health Commercial |
$1,850.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,862.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,087.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,937.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,680.43
|
| Rate for Payer: Blue Shield of California Commercial |
$6,826.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,495.50
|
| Rate for Payer: Cash Price |
$5,087.50
|
| Rate for Payer: Cigna of CA HMO |
$6,475.00
|
| Rate for Payer: Cigna of CA PPO |
$6,475.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,862.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,862.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,862.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,700.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,700.00
|
| Rate for Payer: Galaxy Health WC |
$7,862.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,550.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,169.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,725.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,220.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,475.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,475.00
|
| Rate for Payer: Multiplan Commercial |
$7,400.00
|
| Rate for Payer: Networks By Design Commercial |
$4,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,862.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,550.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,550.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,471.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3,379.03
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,029.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,862.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,862.50
|
| Rate for Payer: Vantage Medical Group Senior |
$7,862.50
|
|
|
HC PACE B/S ACCOLADE SR L300
|
Facility
|
IP
|
$9,250.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813783
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,850.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,850.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,087.50
|
| Rate for Payer: Cash Price |
$5,087.50
|
| Rate for Payer: Cigna of CA HMO |
$6,475.00
|
| Rate for Payer: Cigna of CA PPO |
$6,475.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,700.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,700.00
|
| Rate for Payer: Galaxy Health WC |
$7,862.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,550.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,169.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,524.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,725.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,220.00
|
| Rate for Payer: Multiplan Commercial |
$7,400.00
|
| Rate for Payer: Networks By Design Commercial |
$4,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,862.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,471.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3,379.03
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,029.38
|
|
|
HC PACE BS ADVANTIO DR K063
|
Facility
|
OP
|
$10,325.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813717
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,065.00 |
| Max. Negotiated Rate |
$8,776.25 |
| Rate for Payer: Adventist Health Commercial |
$2,065.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,678.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,743.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,340.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7,619.85
|
| Rate for Payer: Blue Shield of California EPN |
$5,017.95
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cigna of CA HMO |
$7,227.50
|
| Rate for Payer: Cigna of CA PPO |
$7,227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,776.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,776.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,130.00
|
| Rate for Payer: Galaxy Health WC |
$8,776.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,195.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,886.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,391.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,478.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,227.50
|
| Rate for Payer: Multiplan Commercial |
$8,260.00
|
| Rate for Payer: Networks By Design Commercial |
$5,162.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,776.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,874.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3,771.72
|
| Rate for Payer: United Healthcare HMO Rider |
$3,690.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,381.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,776.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,776.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8,776.25
|
|
|
HC PACE BS ADVANTIO DR K063
|
Facility
|
IP
|
$10,325.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813717
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,065.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,065.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cash Price |
$5,678.75
|
| Rate for Payer: Cigna of CA HMO |
$7,227.50
|
| Rate for Payer: Cigna of CA PPO |
$7,227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,130.00
|
| Rate for Payer: Galaxy Health WC |
$8,776.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,195.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,886.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,933.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,391.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,478.00
|
| Rate for Payer: Multiplan Commercial |
$8,260.00
|
| Rate for Payer: Networks By Design Commercial |
$5,162.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,776.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,874.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3,771.72
|
| Rate for Payer: United Healthcare HMO Rider |
$3,690.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,381.44
|
|
|
HC PACE B/S ALTRUA 20 DR S202
|
Facility
|
IP
|
$6,875.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813622
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,375.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,375.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$3,781.25
|
| Rate for Payer: Cash Price |
$3,781.25
|
| Rate for Payer: Cigna of CA HMO |
$4,812.50
|
| Rate for Payer: Cigna of CA PPO |
$4,812.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,750.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,750.00
|
| Rate for Payer: Galaxy Health WC |
$5,843.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,125.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,585.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,619.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,255.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,650.00
|
| Rate for Payer: Multiplan Commercial |
$5,500.00
|
| Rate for Payer: Networks By Design Commercial |
$3,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,843.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,580.19
|
| Rate for Payer: United Healthcare All Other HMO |
$2,511.44
|
| Rate for Payer: United Healthcare HMO Rider |
$2,457.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,251.56
|
|
