|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
IP
|
$30,523.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,104.60 |
| Max. Negotiated Rate |
$25,944.55 |
| Rate for Payer: Adventist Health Commercial |
$6,104.60
|
| Rate for Payer: Cash Price |
$13,735.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12,209.20
|
| Rate for Payer: Galaxy Health WC |
$25,944.55
|
| Rate for Payer: Global Benefits Group Commercial |
$18,313.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,358.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,629.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,893.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,325.52
|
| Rate for Payer: Multiplan Commercial |
$24,418.40
|
| Rate for Payer: Networks By Design Commercial |
$19,839.95
|
| Rate for Payer: Prime Health Services Commercial |
$25,944.55
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
IP
|
$29,665.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,933.00 |
| Max. Negotiated Rate |
$25,215.25 |
| Rate for Payer: Adventist Health Commercial |
$5,933.00
|
| Rate for Payer: Cash Price |
$13,349.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,866.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,866.00
|
| Rate for Payer: Galaxy Health WC |
$25,215.25
|
| Rate for Payer: Global Benefits Group Commercial |
$17,799.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,786.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,302.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,362.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,119.60
|
| Rate for Payer: Multiplan Commercial |
$23,732.00
|
| Rate for Payer: Networks By Design Commercial |
$19,282.25
|
| Rate for Payer: Prime Health Services Commercial |
$25,215.25
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
OP
|
$30,523.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$6,104.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$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 |
$13,735.35
|
| Rate for Payer: Cash Price |
$13,735.35
|
| Rate for Payer: Cash Price |
$13,735.35
|
| Rate for Payer: Cigna of CA HMO |
$19,534.72
|
| Rate for Payer: Cigna of CA PPO |
$22,587.02
|
| 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 |
$25,944.55
|
| Rate for Payer: Global Benefits Group Commercial |
$18,313.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,250.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,358.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,325.52
|
| 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 |
$24,418.40
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$19,839.95
|
| Rate for Payer: Prime Health Services Commercial |
$25,944.55
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,313.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| 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 PACER LEAD REMOVE, DUAL A & V
|
Facility
|
OP
|
$5,822.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$108.21 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| 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 |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$122.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906820121
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,131.80 |
| Max. Negotiated Rate |
$4,810.15 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
IP
|
$5,822.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,164.40 |
| Max. Negotiated Rate |
$4,948.70 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,218.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,603.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906820121
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$108.21 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| 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 |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$122.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
IP
|
$5,822.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,164.40 |
| Max. Negotiated Rate |
$4,948.70 |
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,218.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,603.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
OP
|
$5,822.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$447.20 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| 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 |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$447.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906820120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$447.20 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| 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 |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$447.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906820120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,131.80 |
| Max. Negotiated Rate |
$4,810.15 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
OP
|
$4,214.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906820114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$516.63 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$842.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$1,896.30
|
| Rate for Payer: Cash Price |
$1,896.30
|
| Rate for Payer: Cash Price |
$1,896.30
|
| Rate for Payer: Cigna of CA HMO |
$2,696.96
|
| Rate for Payer: Cigna of CA PPO |
$3,118.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$3,581.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,528.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$516.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,810.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$584.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,011.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$3,371.20
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,739.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,581.90
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,528.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
IP
|
$4,214.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906820114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$842.80 |
| Max. Negotiated Rate |
$3,581.90 |
| Rate for Payer: Adventist Health Commercial |
$842.80
|
| Rate for Payer: Cash Price |
$1,896.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,685.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,685.60
|
| Rate for Payer: Galaxy Health WC |
$3,581.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,528.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,810.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,605.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,608.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,011.36
|
| Rate for Payer: Multiplan Commercial |
$3,371.20
|
| Rate for Payer: Networks By Design Commercial |
$2,739.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,581.90
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
IP
|
$4,336.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$867.20 |
| Max. Negotiated Rate |
$3,685.60 |
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,734.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,734.40
|
| Rate for Payer: Galaxy Health WC |
$3,685.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,601.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,892.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,652.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,683.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Multiplan Commercial |
$3,468.80
|
| Rate for Payer: Networks By Design Commercial |
$2,818.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,685.60
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
OP
|
$4,336.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$516.63 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Galaxy Health WC |
$3,685.60
|
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cigna of CA HMO |
$2,775.04
|
| Rate for Payer: Cigna of CA PPO |
$3,208.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Global Benefits Group Commercial |
$2,601.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$516.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,892.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$584.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$3,468.80
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,818.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,685.60
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,601.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
|
OP
|
$35,599.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906811362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$666.74 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,119.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$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 |
$16,019.55
|
| Rate for Payer: Cash Price |
$16,019.55
|
| Rate for Payer: Cash Price |
$16,019.55
|
| Rate for Payer: Cigna of CA HMO |
$22,783.36
|
| Rate for Payer: Cigna of CA PPO |
$26,343.26
|
| 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 |
$30,259.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21,359.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$666.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,744.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,543.76
|
| 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 |
$28,479.20
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$23,139.35
|
| Rate for Payer: Prime Health Services Commercial |
$30,259.15
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,359.40
|
| 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 PACER UPGRADE SINGLE TO DUAL
|
Facility
|
IP
|
$35,599.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906811362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,119.80 |
| Max. Negotiated Rate |
$30,259.15 |
| Rate for Payer: Adventist Health Commercial |
$7,119.80
|
| Rate for Payer: Cash Price |
$16,019.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,239.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,239.60
|
| Rate for Payer: Galaxy Health WC |
$30,259.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21,359.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,744.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,563.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,035.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,543.76
|
| Rate for Payer: Multiplan Commercial |
$28,479.20
|
| Rate for Payer: Networks By Design Commercial |
$23,139.35
|
| Rate for Payer: Prime Health Services Commercial |
$30,259.15
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
|
IP
|
$34,598.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906820119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,919.60 |
| Max. Negotiated Rate |
$29,408.30 |
| Rate for Payer: Adventist Health Commercial |
$6,919.60
|
| Rate for Payer: Cash Price |
$15,569.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,839.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13,839.20
|
| Rate for Payer: Galaxy Health WC |
$29,408.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20,758.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,076.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,181.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,416.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,303.52
|
| Rate for Payer: Multiplan Commercial |
$27,678.40
|
| Rate for Payer: Networks By Design Commercial |
$22,488.70
|
| Rate for Payer: Prime Health Services Commercial |
$29,408.30
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
|
OP
|
$34,598.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906820119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$666.74 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$6,919.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| 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 |
$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 |
$15,569.10
|
| Rate for Payer: Cash Price |
$15,569.10
|
| Rate for Payer: Cash Price |
$15,569.10
|
| Rate for Payer: Cigna of CA HMO |
$22,142.72
|
| Rate for Payer: Cigna of CA PPO |
$25,602.52
|
| 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 |
$29,408.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20,758.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$666.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,076.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,303.52
|
| 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 |
$27,678.40
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$22,488.70
|
| Rate for Payer: Prime Health Services Commercial |
$29,408.30
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,758.80
|
| 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 PACE ST J ALLURE QUADRA PM3242
|
Facility
|
OP
|
$16,270.00
|
|
|
Service Code
|
CPT C2621
|
| Hospital Charge Code |
906813746
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,254.00 |
| Max. Negotiated Rate |
$13,829.50 |
| Rate for Payer: Adventist Health Commercial |
$3,254.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,829.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,948.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,202.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,991.41
|
| Rate for Payer: Blue Shield of California Commercial |
$12,007.26
|
| Rate for Payer: Blue Shield of California EPN |
$7,907.22
|
| Rate for Payer: Cash Price |
$7,321.50
|
| Rate for Payer: Cigna of CA HMO |
$11,389.00
|
| Rate for Payer: Cigna of CA PPO |
$11,389.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,829.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,829.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,829.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,508.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,508.00
|
| Rate for Payer: Galaxy Health WC |
$13,829.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,762.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,852.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,071.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,904.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,389.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,389.00
|
| Rate for Payer: Multiplan Commercial |
$13,016.00
|
| Rate for Payer: Networks By Design Commercial |
$8,135.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,829.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,762.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,762.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,106.13
|
| Rate for Payer: United Healthcare All Other HMO |
$5,943.43
|
| Rate for Payer: United Healthcare HMO Rider |
$5,814.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,328.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,829.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,829.50
|
| Rate for Payer: Vantage Medical Group Senior |
$13,829.50
|
|
|
HC PACE ST J ALLURE QUADRA PM3242
|
Facility
|
IP
|
$16,270.00
|
|
|
Service Code
|
CPT C2621
|
| Hospital Charge Code |
906813746
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,254.00 |
| Max. Negotiated Rate |
$13,829.50 |
| Rate for Payer: Adventist Health Commercial |
$3,254.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$7,321.50
|
| Rate for Payer: Cash Price |
$7,321.50
|
| Rate for Payer: Cigna of CA HMO |
$11,389.00
|
| Rate for Payer: Cigna of CA PPO |
$11,389.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,508.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,508.00
|
| Rate for Payer: Galaxy Health WC |
$13,829.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,762.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,852.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,198.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,071.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,904.80
|
| Rate for Payer: Multiplan Commercial |
$13,016.00
|
| Rate for Payer: Networks By Design Commercial |
$8,135.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,829.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,106.13
|
| Rate for Payer: United Healthcare All Other HMO |
$5,943.43
|
| Rate for Payer: United Healthcare HMO Rider |
$5,814.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,328.43
|
|
|
HC PACE STJ ALLURE RF PM3222
|
Facility
|
OP
|
$13,895.00
|
|
|
Service Code
|
CPT C2621
|
| Hospital Charge Code |
906813775
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,779.00 |
| Max. Negotiated Rate |
$11,810.75 |
| Rate for Payer: Adventist Health Commercial |
$2,779.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,810.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,642.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,421.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,532.92
|
| Rate for Payer: Blue Shield of California Commercial |
$10,254.51
|
| Rate for Payer: Blue Shield of California EPN |
$6,752.97
|
| Rate for Payer: Cash Price |
$6,252.75
|
| Rate for Payer: Cigna of CA HMO |
$9,726.50
|
| Rate for Payer: Cigna of CA PPO |
$9,726.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,810.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,810.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,810.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,558.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,558.00
|
| Rate for Payer: Galaxy Health WC |
$11,810.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,337.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,267.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,601.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,726.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,726.50
|
| Rate for Payer: Multiplan Commercial |
$11,116.00
|
| Rate for Payer: Networks By Design Commercial |
$6,947.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,810.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,337.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,337.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,214.79
|
| Rate for Payer: United Healthcare All Other HMO |
$5,075.84
|
| Rate for Payer: United Healthcare HMO Rider |
$4,966.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,550.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,810.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,810.75
|
| Rate for Payer: Vantage Medical Group Senior |
$11,810.75
|
|
|
HC PACE STJ ALLURE RF PM3222
|
Facility
|
IP
|
$13,895.00
|
|
|
Service Code
|
CPT C2621
|
| Hospital Charge Code |
906813775
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,779.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$2,779.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$6,252.75
|
| Rate for Payer: Cash Price |
$6,252.75
|
| Rate for Payer: Cigna of CA HMO |
$9,726.50
|
| Rate for Payer: Cigna of CA PPO |
$9,726.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,558.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,558.00
|
| Rate for Payer: Galaxy Health WC |
$11,810.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,337.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,267.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,293.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,601.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.80
|
| Rate for Payer: Multiplan Commercial |
$11,116.00
|
| Rate for Payer: Networks By Design Commercial |
$6,947.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,810.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,214.79
|
| Rate for Payer: United Healthcare All Other HMO |
$5,075.84
|
| Rate for Payer: United Healthcare HMO Rider |
$4,966.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,550.61
|
|
|
HC PACE STJ ASSURITY DR PM2240
|
Facility
|
IP
|
$8,563.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813728
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,712.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,712.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$3,853.35
|
| Rate for Payer: Cash Price |
$3,853.35
|
| Rate for Payer: Cigna of CA HMO |
$5,994.10
|
| Rate for Payer: Cigna of CA PPO |
$5,994.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,425.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,425.20
|
| Rate for Payer: Galaxy Health WC |
$7,278.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,137.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,711.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,262.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,300.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,055.12
|
| Rate for Payer: Multiplan Commercial |
$6,850.40
|
| Rate for Payer: Networks By Design Commercial |
$4,281.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,278.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,213.69
|
| Rate for Payer: United Healthcare All Other HMO |
$3,128.06
|
| Rate for Payer: United Healthcare HMO Rider |
$3,060.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,804.38
|
|
|
HC PACE STJ ASSURITY DR PM2240
|
Facility
|
OP
|
$8,563.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
906813728
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,712.60 |
| Max. Negotiated Rate |
$7,278.55 |
| Rate for Payer: Adventist Health Commercial |
$1,712.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,278.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,709.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,422.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,258.54
|
| Rate for Payer: Blue Shield of California Commercial |
$6,319.49
|
| Rate for Payer: Blue Shield of California EPN |
$4,161.62
|
| Rate for Payer: Cash Price |
$3,853.35
|
| Rate for Payer: Cigna of CA HMO |
$5,994.10
|
| Rate for Payer: Cigna of CA PPO |
$5,994.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,278.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,278.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,278.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,425.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,425.20
|
| Rate for Payer: Galaxy Health WC |
$7,278.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,137.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,711.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,300.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,055.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,994.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,994.10
|
| Rate for Payer: Multiplan Commercial |
$6,850.40
|
| Rate for Payer: Networks By Design Commercial |
$4,281.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,278.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,137.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,137.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,213.69
|
| Rate for Payer: United Healthcare All Other HMO |
$3,128.06
|
| Rate for Payer: United Healthcare HMO Rider |
$3,060.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,804.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,278.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,278.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,278.55
|
|
