|
HC PACE MED MICRA TC SYS MC1VRO1
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813823
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$21,250.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,875.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,750.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,000.00
|
| Rate for Payer: Multiplan Commercial |
$20,000.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC PACE MED MICRA TC SYS MC1VRO1
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813823
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$21,250.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,042.50
|
| Rate for Payer: Blue Shield of California Commercial |
$12,675.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,225.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,875.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,750.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$20,000.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$27,032.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.61 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,406.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$12,164.40
|
| Rate for Payer: Cash Price |
$12,164.40
|
| Rate for Payer: Cash Price |
$12,164.40
|
| Rate for Payer: Cigna of CA HMO |
$17,300.48
|
| Rate for Payer: Cigna of CA PPO |
$20,003.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$22,977.20
|
| Rate for Payer: Global Benefits Group Commercial |
$16,219.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$486.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,165.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$550.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,487.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$21,625.60
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$17,570.80
|
| Rate for Payer: Prime Health Services Commercial |
$22,977.20
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,219.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,516.00
|
| 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 |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$27,032.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,406.40 |
| Max. Negotiated Rate |
$22,977.20 |
| Rate for Payer: Adventist Health Commercial |
$5,406.40
|
| Rate for Payer: Cash Price |
$12,164.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,812.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,812.80
|
| Rate for Payer: Galaxy Health WC |
$22,977.20
|
| Rate for Payer: Global Benefits Group Commercial |
$16,219.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,165.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,948.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,487.68
|
| Rate for Payer: Multiplan Commercial |
$21,625.60
|
| Rate for Payer: Networks By Design Commercial |
$17,570.80
|
| Rate for Payer: Prime Health Services Commercial |
$22,977.20
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$31,426.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,285.20 |
| Max. Negotiated Rate |
$26,712.10 |
| Rate for Payer: Adventist Health Commercial |
$6,285.20
|
| Rate for Payer: Cash Price |
$14,141.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,998.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,570.40
|
| Rate for Payer: EPIC Health Plan Senior |
$12,570.40
|
| Rate for Payer: Galaxy Health WC |
$26,712.10
|
| Rate for Payer: Global Benefits Group Commercial |
$18,855.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,955.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,541.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,542.24
|
| Rate for Payer: Multiplan Commercial |
$25,140.80
|
| Rate for Payer: Networks By Design Commercial |
$20,426.90
|
| Rate for Payer: Prime Health Services Commercial |
$26,712.10
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$31,426.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$6,285.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$14,141.70
|
| Rate for Payer: Cash Price |
$14,141.70
|
| Rate for Payer: Cash Price |
$14,141.70
|
| Rate for Payer: Cigna of CA HMO |
$20,112.64
|
| Rate for Payer: Cigna of CA PPO |
$23,255.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,998.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$26,712.10
|
| Rate for Payer: Global Benefits Group Commercial |
$18,855.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,955.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,542.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,214.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$25,140.80
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$20,426.90
|
| Rate for Payer: Prime Health Services Commercial |
$26,712.10
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,855.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,713.00
|
| 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 |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$22,221.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.22 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,444.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$9,999.45
|
| Rate for Payer: Cash Price |
$9,999.45
|
| Rate for Payer: Cash Price |
$9,999.45
|
| Rate for Payer: Cigna of CA HMO |
$14,221.44
|
| Rate for Payer: Cigna of CA PPO |
$16,443.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,554.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$18,887.85
|
| Rate for Payer: Global Benefits Group Commercial |
$13,332.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$467.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,110.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$528.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,333.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$17,776.80
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$14,443.65
|
| Rate for Payer: Prime Health Services Commercial |
$18,887.85
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,332.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,110.50
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$22,221.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,444.20 |
| Max. Negotiated Rate |
$18,887.85 |
| Rate for Payer: Adventist Health Commercial |
$4,444.20
|
| Rate for Payer: Cash Price |
$9,999.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,554.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,888.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,888.40
|
| Rate for Payer: Galaxy Health WC |
$18,887.85
|
| Rate for Payer: Global Benefits Group Commercial |
$13,332.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,110.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,110.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,333.04
|
| Rate for Payer: Multiplan Commercial |
$17,776.80
|
| Rate for Payer: Networks By Design Commercial |
$14,443.65
|
| Rate for Payer: Prime Health Services Commercial |
$18,887.85
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$9,558.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,911.60 |
| Max. Negotiated Rate |
$8,124.30 |
| Rate for Payer: Adventist Health Commercial |
$1,911.60
|
| Rate for Payer: Cash Price |
$4,301.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,690.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,823.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,823.20
|
| Rate for Payer: Galaxy Health WC |
$8,124.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,734.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,069.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,639.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,293.92
|
| Rate for Payer: Multiplan Commercial |
$7,646.40
|
| Rate for Payer: Networks By Design Commercial |
$6,212.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,124.30
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$9,558.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$261.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,911.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$4,301.10
|
| Rate for Payer: Cash Price |
$4,301.10
|
| Rate for Payer: Cash Price |
$4,301.10
|
| Rate for Payer: Cigna of CA HMO |
$6,117.12
|
| Rate for Payer: Cigna of CA PPO |
$7,072.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,690.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$8,124.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,734.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$261.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,069.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$295.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,293.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$7,646.40
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$6,212.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,124.30
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,734.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,779.00
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$26,727.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,345.40 |
| Max. Negotiated Rate |
$22,717.95 |
| Rate for Payer: Adventist Health Commercial |
$5,345.40
|
| Rate for Payer: Cash Price |
$12,027.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,708.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,690.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,690.80
|
| Rate for Payer: Galaxy Health WC |
$22,717.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,036.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,971.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,768.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,414.48
|
| Rate for Payer: Multiplan Commercial |
$21,381.60
|
| Rate for Payer: Networks By Design Commercial |
$17,372.55
|
| Rate for Payer: Prime Health Services Commercial |
$22,717.95
|
|
|
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 |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$12,027.15
|
| Rate for Payer: Cash Price |
$12,027.15
|
| Rate for Payer: Cash Price |
$12,027.15
|
| 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 |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,708.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| 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/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$597.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,971.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,414.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,013.63
|
| 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 |
$13,363.50
|
| 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 |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
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 |
$11,542.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,955.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$16,287.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,133.50
|
| 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 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 |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$11,542.50
|
| Rate for Payer: Cash Price |
$11,542.50
|
| Rate for Payer: Cash Price |
$11,542.50
|
| 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 |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| 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/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$495.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,287.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,156.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,410.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,262.33
|
| 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 |
$12,825.00
|
| 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 |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
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 |
$12,647.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,673.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$17,846.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,581.95
|
| 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
|
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 |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$12,647.25
|
| Rate for Payer: Cash Price |
$12,647.25
|
| Rate for Payer: Cash Price |
$12,647.25
|
| 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 |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,673.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| 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/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,250.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,846.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,745.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,013.63
|
| 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 |
$14,052.50
|
| 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 |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
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 |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$13,049.55
|
| Rate for Payer: Cash Price |
$13,049.55
|
| Rate for Payer: Cash Price |
$13,049.55
|
| 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 |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,299.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| 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/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,250.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,414.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,959.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,013.63
|
| 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 |
$14,499.50
|
| 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 |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
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 |
$13,049.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,299.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$18,414.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,109.41
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,366.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$19,382.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,008.57
|
| 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
|
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 |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$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 |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,366.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| 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/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,250.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,382.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,325.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,013.63
|
| 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 |
$15,261.50
|
| 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 |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$122.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,911.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,434.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC 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: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,328.80
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,434.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
|
|
HC 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cash Price |
$2,619.90
|
| Rate for Payer: Cigna of CA HMO |
$3,726.08
|
| Rate for Payer: Cigna of CA PPO |
$4,308.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,075.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$4,948.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,493.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$447.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$4,657.60
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,784.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,948.70
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,911.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$867.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cigna of CA HMO |
$2,775.04
|
| Rate for Payer: Cigna of CA PPO |
$3,208.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,035.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,378.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,919.09
|
| Rate for Payer: Galaxy Health WC |
$3,685.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,601.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,352.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$516.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,753.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$584.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,715.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,343.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,555.98
|
| Rate for Payer: Multiplan Commercial |
$3,468.80
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,818.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,685.60
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,601.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,168.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,653.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
