|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$26,727.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$597.95 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,345.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$14,699.85
|
| Rate for Payer: Cash Price |
$14,699.85
|
| Rate for Payer: Cash Price |
$14,699.85
|
| Rate for Payer: Cigna of CA HMO |
$17,105.28
|
| Rate for Payer: Cigna of CA PPO |
$19,777.98
|
| 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 |
$22,717.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,036.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$597.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,826.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,414.48
|
| 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 |
$21,381.60
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$17,372.55
|
| Rate for Payer: Prime Health Services Commercial |
$22,717.95
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,036.20
|
| 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 INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$597.95 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cigna of CA HMO |
$16,624.64
|
| Rate for Payer: Cigna of CA PPO |
$19,222.24
|
| 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 |
$22,079.60
|
| Rate for Payer: Global Benefits Group Commercial |
$15,585.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$597.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,325.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,234.24
|
| 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 |
$20,780.80
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$16,884.40
|
| Rate for Payer: Prime Health Services Commercial |
$22,079.60
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,585.60
|
| 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 INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,195.20 |
| Max. Negotiated Rate |
$22,079.60 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,390.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,390.40
|
| Rate for Payer: Galaxy Health WC |
$22,079.60
|
| Rate for Payer: Global Benefits Group Commercial |
$15,585.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,325.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,896.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,079.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,234.24
|
| Rate for Payer: Multiplan Commercial |
$20,780.80
|
| Rate for Payer: Networks By Design Commercial |
$16,884.40
|
| Rate for Payer: Prime Health Services Commercial |
$22,079.60
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$25,650.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.99 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,130.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$14,107.50
|
| Rate for Payer: Cash Price |
$14,107.50
|
| Rate for Payer: Cash Price |
$14,107.50
|
| Rate for Payer: Cigna of CA HMO |
$16,416.00
|
| Rate for Payer: Cigna of CA PPO |
$18,981.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$21,802.50
|
| Rate for Payer: Global Benefits Group Commercial |
$15,390.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$495.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,108.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,156.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$20,520.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$16,672.50
|
| Rate for Payer: Prime Health Services Commercial |
$21,802.50
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,390.00
|
| 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 |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.99 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$7,415.66
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cigna of CA HMO |
$15,953.92
|
| Rate for Payer: Cigna of CA PPO |
$18,446.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$21,188.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,956.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$495.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,626.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,982.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$19,942.40
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$16,203.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,188.80
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,956.80
|
| 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 |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,985.60 |
| Max. Negotiated Rate |
$21,188.80 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,971.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,971.20
|
| Rate for Payer: Galaxy Health WC |
$21,188.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,956.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,626.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,497.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,430.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,982.72
|
| Rate for Payer: Multiplan Commercial |
$19,942.40
|
| Rate for Payer: Networks By Design Commercial |
$16,203.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,188.80
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$25,650.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,130.00 |
| Max. Negotiated Rate |
$21,802.50 |
| Rate for Payer: Adventist Health Commercial |
$5,130.00
|
| Rate for Payer: Cash Price |
$14,107.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,260.00
|
| Rate for Payer: Galaxy Health WC |
$21,802.50
|
| Rate for Payer: Global Benefits Group Commercial |
$15,390.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,108.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,772.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,877.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,156.00
|
| Rate for Payer: Multiplan Commercial |
$20,520.00
|
| Rate for Payer: Networks By Design Commercial |
$16,672.50
|
| Rate for Payer: Prime Health Services Commercial |
$21,802.50
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$28,105.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,621.00 |
| Max. Negotiated Rate |
$23,889.25 |
| Rate for Payer: Adventist Health Commercial |
$5,621.00
|
| Rate for Payer: Cash Price |
$15,457.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,242.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,242.00
|
| Rate for Payer: Galaxy Health WC |
$23,889.25
|
| Rate for Payer: Global Benefits Group Commercial |
$16,863.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,746.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,708.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,396.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,745.20
|
| Rate for Payer: Multiplan Commercial |
$22,484.00
|
| Rate for Payer: Networks By Design Commercial |
$18,268.25
|
| Rate for Payer: Prime Health Services Commercial |
$23,889.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,463.00 |
| Max. Negotiated Rate |
$23,217.75 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,926.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,926.00
|
| Rate for Payer: Galaxy Health WC |
$23,217.75
|
| Rate for Payer: Global Benefits Group Commercial |
$16,389.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,219.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,407.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,907.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,555.60
|
| Rate for Payer: Multiplan Commercial |
$21,852.00
|
| Rate for Payer: Networks By Design Commercial |
$17,754.75
|
| Rate for Payer: Prime Health Services Commercial |
$23,217.75
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$28,105.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,621.00
|
| 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 |
$15,457.75
|
| Rate for Payer: Cash Price |
$15,457.75
|
| Rate for Payer: Cash Price |
$15,457.75
|
| Rate for Payer: Cigna of CA HMO |
$17,987.20
|
| Rate for Payer: Cigna of CA PPO |
$20,797.70
|
| 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 |
$23,889.25
|
| Rate for Payer: Global Benefits Group Commercial |
$16,863.00
|
| 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 |
$18,746.03
|
| 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 |
$6,745.20
|
| 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 |
$22,484.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$18,268.25
|
| Rate for Payer: Prime Health Services Commercial |
$23,889.25
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,863.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: 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 INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| 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 |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cigna of CA HMO |
$17,481.60
|
| Rate for Payer: Cigna of CA PPO |
$20,213.10
|
| 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 |
$23,217.75
|
| Rate for Payer: Global Benefits Group Commercial |
$16,389.00
|
| 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 |
$18,219.10
|
| 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 |
$6,555.60
|
| 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 |
$21,852.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$17,754.75
|
| Rate for Payer: Prime Health Services Commercial |
$23,217.75
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,389.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: 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 INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$28,999.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,799.80
|
| 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 |
$15,949.45
|
| Rate for Payer: Cash Price |
$15,949.45
|
| Rate for Payer: Cash Price |
$15,949.45
|
| Rate for Payer: Cigna of CA HMO |
$18,559.36
|
| Rate for Payer: Cigna of CA PPO |
$21,459.26
|
| 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 |
$24,649.15
|
| Rate for Payer: Global Benefits Group Commercial |
$17,399.40
|
| 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 |
$19,342.33
|
| 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 |
$6,959.76
|
| 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 |
$23,199.20
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$18,849.35
|
| Rate for Payer: Prime Health Services Commercial |
$24,649.15
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,399.40
|
| 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 INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$28,999.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,799.80 |
| Max. Negotiated Rate |
$24,649.15 |
| Rate for Payer: Adventist Health Commercial |
$5,799.80
|
| Rate for Payer: Cash Price |
$15,949.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,599.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11,599.60
|
| Rate for Payer: Galaxy Health WC |
$24,649.15
|
| Rate for Payer: Global Benefits Group Commercial |
$17,399.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,342.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,048.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,950.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,959.76
|
| Rate for Payer: Multiplan Commercial |
$23,199.20
|
| Rate for Payer: Networks By Design Commercial |
$18,849.35
|
| Rate for Payer: Prime Health Services Commercial |
$24,649.15
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$28,184.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,636.80
|
| 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 |
$15,501.20
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Cigna of CA HMO |
$18,037.76
|
| Rate for Payer: Cigna of CA PPO |
$20,856.16
|
| 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 |
$23,956.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,910.40
|
| 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 |
$18,798.73
|
| 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 |
$6,764.16
|
| 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 |
$22,547.20
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$18,319.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,956.40
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,910.40
|
| 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 INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$28,184.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,636.80 |
| Max. Negotiated Rate |
$23,956.40 |
| Rate for Payer: Adventist Health Commercial |
$5,636.80
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11,273.60
|
| Rate for Payer: Galaxy Health WC |
$23,956.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,910.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,798.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,738.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,445.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,764.16
|
| Rate for Payer: Multiplan Commercial |
$22,547.20
|
| Rate for Payer: Networks By Design Commercial |
$18,319.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,956.40
|
|
|
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 |
$16,787.65
|
| 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 |
$16,315.75
|
| 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 |
$16,787.65
|
| Rate for Payer: Cash Price |
$16,787.65
|
| Rate for Payer: Cash Price |
$16,787.65
|
| 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 INSERT/RPL, WITH V-LEAD
|
Facility
|
OP
|
$29,665.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.93 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,933.00
|
| 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 |
$16,315.75
|
| Rate for Payer: Cash Price |
$16,315.75
|
| Rate for Payer: Cash Price |
$16,315.75
|
| Rate for Payer: Cigna of CA HMO |
$18,985.60
|
| Rate for Payer: Cigna of CA PPO |
$21,952.10
|
| 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 |
$25,215.25
|
| Rate for Payer: Global Benefits Group Commercial |
$17,799.00
|
| 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 |
$19,786.56
|
| 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 |
$7,119.60
|
| 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 |
$23,732.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$19,282.25
|
| Rate for Payer: Prime Health Services Commercial |
$25,215.25
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,799.00
|
| 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
|
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 |
$3,112.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.16
|
| Rate for Payer: Multiplan Commercial |
$4,527.20
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC 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 |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$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, 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 |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$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
|
$5,822.00
|
|
|
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 |
$3,202.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,883.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,218.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,603.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC 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 |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cash Price |
$3,202.10
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$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 |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$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
|
|
