|
HC SUBSTERN ICD DFIB TEST
|
Facility
|
IP
|
$4,929.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906810577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$985.80 |
| Max. Negotiated Rate |
$4,436.10 |
| Rate for Payer: Adventist Health Commercial |
$985.80
|
| Rate for Payer: Cash Price |
$2,710.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,943.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,971.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,971.60
|
| Rate for Payer: Galaxy Health WC |
$4,189.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,957.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,436.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,287.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,877.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,051.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$985.80
|
| Rate for Payer: Multiplan Commercial |
$3,696.75
|
| Rate for Payer: Networks By Design Commercial |
$3,203.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,189.65
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
|
OP
|
$4,929.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906810577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$985.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,542.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,542.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,386.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,894.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,457.69
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,710.95
|
| Rate for Payer: Cash Price |
$2,710.95
|
| Rate for Payer: Cash Price |
$2,710.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,943.20
|
| Rate for Payer: Cigna of CA HMO |
$3,154.56
|
| Rate for Payer: Cigna of CA PPO |
$3,647.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,696.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.38
|
| Rate for Payer: EPIC Health Plan Senior |
$1,542.50
|
| Rate for Payer: Galaxy Health WC |
$4,189.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,957.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,436.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,529.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,542.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,313.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,287.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,877.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,542.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$985.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,066.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,066.95
|
| Rate for Payer: Multiplan Commercial |
$3,696.75
|
| Rate for Payer: Multiplan WC |
$2,457.69
|
| Rate for Payer: Networks By Design Commercial |
$3,203.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,542.50
|
| Rate for Payer: Preferred Health Network WC |
$2,507.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,189.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,635.05
|
| Rate for Payer: Prime Health Services WC |
$2,432.61
|
| Rate for Payer: Riverside University Health System MISP |
$1,696.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,957.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,464.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,464.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,464.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,464.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,542.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.50
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,135.00 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,270.00
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,842.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
IP
|
$64,324.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,864.80 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,729.60
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,816.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,641.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,443.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: Cigna of CA HMO |
$48,432.00
|
| Rate for Payer: Cigna of CA PPO |
$55,999.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
OP
|
$64,324.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,145.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,777.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: Cigna of CA HMO |
$41,167.36
|
| Rate for Payer: Cigna of CA PPO |
$47,599.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,594.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
IP
|
$64,324.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,864.80 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,729.60
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,816.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,135.00 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,270.00
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,842.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
OP
|
$64,324.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,145.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,777.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: Cigna of CA HMO |
$41,167.36
|
| Rate for Payer: Cigna of CA PPO |
$47,599.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,594.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,641.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,443.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: Cigna of CA HMO |
$48,432.00
|
| Rate for Payer: Cigna of CA PPO |
$55,999.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906820277
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,641.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,443.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: Cigna of CA HMO |
$48,432.00
|
| Rate for Payer: Cigna of CA PPO |
$55,999.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906820277
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,135.00 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,270.00
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,842.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
IP
|
$64,324.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906810574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,864.80 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,729.60
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,816.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
OP
|
$64,324.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906810574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,145.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,777.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: Cigna of CA HMO |
$41,167.36
|
| Rate for Payer: Cigna of CA PPO |
$47,599.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,594.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906820279
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,131.80 |
| Max. Negotiated Rate |
$5,093.10 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,093.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,131.80
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906810580
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$962.00 |
| Max. Negotiated Rate |
$4,329.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,924.00
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,208.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,832.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,977.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906810580
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,329.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,824.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Cigna of CA HMO |
$3,078.40
|
| Rate for Payer: Cigna of CA PPO |
$3,559.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,208.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,832.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,886.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906820279
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,740.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,323.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,527.20
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,093.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,131.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
IP
|
$64,324.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906810571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,864.80 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,729.60
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,816.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
OP
|
$64,324.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906810571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,145.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,777.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Cash Price |
$35,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: Cigna of CA HMO |
$41,167.36
|
| Rate for Payer: Cigna of CA PPO |
$47,599.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,594.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906820274
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,641.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,443.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: Cigna of CA HMO |
$48,432.00
|
| Rate for Payer: Cigna of CA PPO |
$55,999.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906820274
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,135.00 |
| Max. Negotiated Rate |
$68,107.50 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Central Health Plan Commercial |
$60,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,270.00
|
| Rate for Payer: Galaxy Health WC |
$64,323.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,107.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,475.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,832.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,842.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,135.00
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Networks By Design Commercial |
$49,188.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,323.75
|
|
|
HC SUDAN BLACK B
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900910057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC SUDAN BLACK B
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900910057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$268.60 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.29
|
| Rate for Payer: Blue Shield of California Commercial |
$82.55
|
| Rate for Payer: Blue Shield of California EPN |
$53.99
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC SUDAN BLACK B
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
903800259
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
