|
HC SUBC THER INFUSION UP TO 1 HR
|
Facility
IP
|
$588.00
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
907296369
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$117.60 |
| Max. Negotiated Rate |
$529.20 |
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Central Health Plan Commercial |
$470.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.20
|
| Rate for Payer: Galaxy Health WC |
$499.80
|
| Rate for Payer: Global Benefits Group Commercial |
$352.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$529.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$392.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$117.60
|
| Rate for Payer: Multiplan Commercial |
$441.00
|
| Rate for Payer: Networks By Design Commercial |
$382.20
|
| Rate for Payer: Prime Health Services Commercial |
$499.80
|
|
|
HC SUBC THER INFUSION UP TO 1 HR
|
Facility
OP
|
$588.00
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
907296369
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$117.60 |
| Max. Negotiated Rate |
$1,034.42 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,034.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$352.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Central Health Plan Commercial |
$470.40
|
| Rate for Payer: Cigna of CA HMO |
$376.32
|
| Rate for Payer: Cigna of CA PPO |
$435.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$499.80
|
| Rate for Payer: Global Benefits Group Commercial |
$352.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$529.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$441.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$392.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$117.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$441.00
|
| Rate for Payer: Networks By Design Commercial |
$382.20
|
| Rate for Payer: Prime Health Services Commercial |
$499.80
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$352.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC SUBDURAL TAP UNIL/BILAT INIT
|
Facility
OP
|
$2,085.00
|
|
|
Service Code
|
CPT 61000
|
| Hospital Charge Code |
900501225
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,251.00
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Cigna of CA PPO |
$1,542.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,876.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,563.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$864.04
|
| Rate for Payer: Innovage PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,390.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,563.75
|
| Rate for Payer: Networks By Design Commercial |
$1,355.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,772.25
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,251.00
|
| Rate for Payer: Riverside University Health MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,251.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,042.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,042.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,042.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SUBDURAL TAP UNIL/BILAT INIT
|
Facility
IP
|
$2,085.00
|
|
|
Service Code
|
CPT 61000
|
| Hospital Charge Code |
900501225
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$417.00 |
| Max. Negotiated Rate |
$1,876.50 |
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,668.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.00
|
| Rate for Payer: Galaxy Health WC |
$1,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,876.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,390.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.00
|
| Rate for Payer: Multiplan Commercial |
$1,563.75
|
| Rate for Payer: Networks By Design Commercial |
$1,355.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,772.25
|
|
|
HC SUBDURAL TAP UNIL/BILAT INIT
|
Facility
OP
|
$2,085.00
|
|
|
Service Code
|
CPT 61000
|
| Hospital Charge Code |
900501225
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$417.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,251.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,311.46
|
| Rate for Payer: Blue Shield of California EPN |
$1,019.56
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Cigna of CA HMO |
$1,334.40
|
| Rate for Payer: Cigna of CA PPO |
$1,542.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,876.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,563.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: IEHP medi-cal |
$1,425.67
|
| Rate for Payer: IEHP Medicare Advantage |
$864.04
|
| Rate for Payer: Innovage PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,390.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,563.75
|
| Rate for Payer: Networks By Design Commercial |
$1,355.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,772.25
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,251.00
|
| Rate for Payer: Riverside University Health MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,251.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,251.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,042.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,042.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,042.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SUBDURAL TAP UNIL/BILAT INIT
|
Facility
IP
|
$2,085.00
|
|
|
Service Code
|
CPT 61000
|
| Hospital Charge Code |
900501225
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$417.00 |
| Max. Negotiated Rate |
$1,876.50 |
| Rate for Payer: Cash Price |
$938.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,668.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.00
|
| Rate for Payer: Galaxy Health WC |
$1,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,876.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,390.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.00
|
| Rate for Payer: Multiplan Commercial |
$1,563.75
|
| Rate for Payer: Networks By Design Commercial |
$1,355.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,772.25
|
|
|
HC SUBQ ICD LEAD INSERT
|
Facility
OP
|
$23,165.00
|
|
|
Service Code
|
CPT 33271
|
| Hospital Charge Code |
950442236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,633.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: BCBS Transplant Transplant |
$13,899.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$10,614.79
|
| Rate for Payer: Cash Price |
$10,424.25
|
| Rate for Payer: Cash Price |
$10,424.25
|
| Rate for Payer: Cash Price |
$10,424.25
|
| Rate for Payer: Central Health Plan Commercial |
$18,532.00
|
| Rate for Payer: Cigna of CA PPO |
$17,142.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$19,690.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,899.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,848.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,373.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: IEHP medi-cal |
$17,514.40
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Innovage PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,451.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,633.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$17,373.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$15,057.25
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$19,690.25
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13,899.00
|
| Rate for Payer: Riverside University Health MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,899.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC SUBQ ICD LEAD INSERT
|
Facility
IP
|
$23,165.00
|
|
|
Service Code
|
CPT 33271
|
| Hospital Charge Code |
950442236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,633.00 |
| Max. Negotiated Rate |
$20,848.50 |
| Rate for Payer: Cash Price |
$10,424.25
|
| Rate for Payer: Central Health Plan Commercial |
$18,532.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,266.00
|
| Rate for Payer: Galaxy Health WC |
$19,690.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,899.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,848.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,451.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,633.00
|
| Rate for Payer: Multiplan Commercial |
$17,373.75
|
| Rate for Payer: Networks By Design Commercial |
$15,057.25
|
| Rate for Payer: Prime Health Services Commercial |
$19,690.25
|
|
|
HC SUBQ ICD REMOVAL ONLY
|
Facility
IP
|
$9,777.00
|
|
|
Service Code
|
CPT 33272
|
| Hospital Charge Code |
950442237
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,955.40 |
| Max. Negotiated Rate |
$8,799.30 |
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,910.80
|
| Rate for Payer: Galaxy Health WC |
$8,310.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,866.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,799.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,521.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,955.40
|
| Rate for Payer: Multiplan Commercial |
$7,332.75
|
| Rate for Payer: Networks By Design Commercial |
$6,355.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,310.45
|
|
|
HC SUBQ ICD REMOVAL ONLY
|
Facility
OP
|
$9,777.00
|
|
|
Service Code
|
CPT 33272
|
| Hospital Charge Code |
950442237
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$40,548.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,866.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,821.60
|
| Rate for Payer: Cigna of CA PPO |
$7,234.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$8,310.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,866.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,799.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,332.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: IEHP medi-cal |
$8,095.79
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Innovage PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,521.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,955.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$7,332.75
|
| Rate for Payer: Networks By Design Commercial |
$6,355.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,310.45
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,866.20
|
| Rate for Payer: Riverside University Health MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,866.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC SUBQ LEAD REPOSITION
|
Facility
OP
|
$9,777.00
|
|
|
Service Code
|
CPT 33273
|
| Hospital Charge Code |
950442238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,955.40 |
| Max. Negotiated Rate |
$40,548.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,866.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,821.60
|
| Rate for Payer: Cigna of CA PPO |
$7,234.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$8,310.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,866.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,799.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,332.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: IEHP medi-cal |
$8,095.79
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Innovage PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,521.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,955.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$7,332.75
|
| Rate for Payer: Networks By Design Commercial |
$6,355.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,310.45
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,866.20
|
| Rate for Payer: Riverside University Health MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,866.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC SUBQ LEAD REPOSITION
|
Facility
IP
|
$9,777.00
|
|
|
Service Code
|
CPT 33273
|
| Hospital Charge Code |
950442238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,955.40 |
| Max. Negotiated Rate |
$8,799.30 |
| Rate for Payer: Cash Price |
$4,399.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,910.80
|
| Rate for Payer: Galaxy Health WC |
$8,310.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,866.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,799.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,521.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,955.40
|
| Rate for Payer: Multiplan Commercial |
$7,332.75
|
| Rate for Payer: Networks By Design Commercial |
$6,355.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,310.45
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
IP
|
$4,152.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906810577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$830.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,660.80
|
| Rate for Payer: Galaxy Health WC |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,769.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
OP
|
$4,152.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906810577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$3,736.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,063.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,010.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,453.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,491.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: Cigna of CA PPO |
$3,072.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,114.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: IEHP medi-cal |
$2,453.53
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Innovage PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,769.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$2,698.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,491.20
|
| Rate for Payer: Riverside University Health MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,491.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,076.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,076.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,076.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,076.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
OP
|
$4,152.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906820278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$3,736.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,063.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,010.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,453.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,491.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: Cigna of CA PPO |
$3,072.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,114.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: IEHP medi-cal |
$2,453.53
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Innovage PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,769.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$2,698.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,491.20
|
| Rate for Payer: Riverside University Health MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,491.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,076.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,076.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,076.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,076.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
IP
|
$4,152.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906820278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$830.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,660.80
|
| Rate for Payer: Galaxy Health WC |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,769.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: BCBS Transplant Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$10,614.79
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: IEHP medi-cal |
$17,514.40
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Innovage PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$47,794.80
|
| Rate for Payer: Riverside University Health MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: BCBS Transplant Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$10,614.79
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: IEHP medi-cal |
$17,514.40
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Innovage PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$47,794.80
|
| Rate for Payer: Riverside University Health MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: IEHP medi-cal |
$8,095.79
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Innovage PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$47,794.80
|
| Rate for Payer: Riverside University Health MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: IEHP medi-cal |
$8,095.79
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Innovage PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$47,794.80
|
| Rate for Payer: Riverside University Health MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906810574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
