|
HC DFIB BIOTRONIK IPERIA 7 DR-T 392423
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,415.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC DFIB BIOTRONIK IPERIA 7 DR-T 392423
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC DFIB BIOTRONIK IPERIA VR 393032
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
906813788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC DFIB BIOTRONIK IPERIA VR 393032
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
906813788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,415.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC DFIB BIOTRONIK ITREVIA 392412
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,415.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC DFIB BIOTRONIK ITREVIA 392412
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC DFIB B/S ASSURA MP 3369
|
Facility
|
OP
|
$25,088.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,017.60 |
| Max. Negotiated Rate |
$22,579.20 |
| Rate for Payer: Adventist Health Commercial |
$5,017.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,324.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,798.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,816.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,455.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,891.23
|
| Rate for Payer: Blue Shield of California Commercial |
$19,393.02
|
| Rate for Payer: Blue Shield of California EPN |
$12,644.35
|
| Rate for Payer: Cash Price |
$13,798.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,070.40
|
| Rate for Payer: Cigna of CA HMO |
$17,561.60
|
| Rate for Payer: Cigna of CA PPO |
$17,561.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,324.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,324.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,035.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,035.20
|
| Rate for Payer: Galaxy Health WC |
$21,324.80
|
| Rate for Payer: Global Benefits Group Commercial |
$15,052.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,579.20
|
| Rate for Payer: InnovAge PACE Commercial |
$12,544.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,733.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,529.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,017.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,561.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,561.60
|
| Rate for Payer: Multiplan Commercial |
$18,816.00
|
| Rate for Payer: Networks By Design Commercial |
$12,544.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,324.80
|
| Rate for Payer: Riverside University Health System MISP |
$10,035.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,052.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,052.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,415.53
|
| Rate for Payer: United Healthcare All Other HMO |
$9,164.65
|
| Rate for Payer: United Healthcare HMO Rider |
$8,966.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,216.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,324.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,324.80
|
| Rate for Payer: Vantage Medical Group Senior |
$21,324.80
|
|
|
HC DFIB B/S ASSURA MP 3369
|
Facility
|
IP
|
$25,088.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,017.60 |
| Max. Negotiated Rate |
$22,579.20 |
| Rate for Payer: Adventist Health Commercial |
$5,017.60
|
| Rate for Payer: Blue Shield of California Commercial |
$19,393.02
|
| Rate for Payer: Blue Shield of California EPN |
$12,644.35
|
| Rate for Payer: Cash Price |
$13,798.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,070.40
|
| Rate for Payer: Cigna of CA HMO |
$17,561.60
|
| Rate for Payer: Cigna of CA PPO |
$17,561.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,035.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,035.20
|
| Rate for Payer: Galaxy Health WC |
$21,324.80
|
| Rate for Payer: Global Benefits Group Commercial |
$15,052.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,579.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,733.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,558.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,529.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,017.60
|
| Rate for Payer: Multiplan Commercial |
$18,816.00
|
| Rate for Payer: Networks By Design Commercial |
$12,544.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,324.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,415.53
|
| Rate for Payer: United Healthcare All Other HMO |
$9,164.65
|
| Rate for Payer: United Healthcare HMO Rider |
$8,966.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,216.32
|
|
|
HC DFIB B/S COGNIS 100-D N118
|
Facility
|
OP
|
$29,610.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,922.00 |
| Max. Negotiated Rate |
$26,649.00 |
| Rate for Payer: Adventist Health Commercial |
$5,922.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,285.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,207.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,519.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,395.06
|
| Rate for Payer: Blue Shield of California Commercial |
$22,888.53
|
| Rate for Payer: Blue Shield of California EPN |
$14,923.44
|
| Rate for Payer: Cash Price |
$16,285.50
|
| Rate for Payer: Central Health Plan Commercial |
$23,688.00
|
| Rate for Payer: Cigna of CA HMO |
$20,727.00
|
| Rate for Payer: Cigna of CA PPO |
$20,727.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,168.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,168.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,844.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,844.00
|
| Rate for Payer: Galaxy Health WC |
$25,168.50
|
| Rate for Payer: Global Benefits Group Commercial |
$17,766.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,649.00
|
| Rate for Payer: InnovAge PACE Commercial |
$14,805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,749.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,328.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,922.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,727.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,727.00
|
| Rate for Payer: Multiplan Commercial |
$22,207.50
|
| Rate for Payer: Networks By Design Commercial |
$14,805.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,168.50
|
| Rate for Payer: Riverside University Health System MISP |
$11,844.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,766.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,766.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,112.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10,816.53
|
| Rate for Payer: United Healthcare HMO Rider |
$10,582.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,697.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,168.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25,168.50
|
|
|
HC DFIB B/S COGNIS 100-D N118
|
Facility
|
IP
|
$29,610.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,922.00 |
| Max. Negotiated Rate |
$26,649.00 |
| Rate for Payer: Adventist Health Commercial |
$5,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,888.53
|
| Rate for Payer: Blue Shield of California EPN |
$14,923.44
|
| Rate for Payer: Cash Price |
$16,285.50
|
| Rate for Payer: Central Health Plan Commercial |
$23,688.00
|
| Rate for Payer: Cigna of CA HMO |
$20,727.00
|
| Rate for Payer: Cigna of CA PPO |
$20,727.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,844.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,844.00
|
| Rate for Payer: Galaxy Health WC |
$25,168.50
|
| Rate for Payer: Global Benefits Group Commercial |
$17,766.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,649.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,749.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,281.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,328.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,922.00
|
| Rate for Payer: Multiplan Commercial |
$22,207.50
|
| Rate for Payer: Networks By Design Commercial |
$14,805.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,168.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,112.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10,816.53
|
| Rate for Payer: United Healthcare HMO Rider |
$10,582.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,697.27
|
|
|
HC DFIB B/S COGNIS 100-D N119
|
Facility
|
IP
|
$29,610.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,922.00 |
| Max. Negotiated Rate |
$26,649.00 |
| Rate for Payer: Adventist Health Commercial |
$5,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,888.53
|
| Rate for Payer: Blue Shield of California EPN |
$14,923.44
|
| Rate for Payer: Cash Price |
$16,285.50
|
| Rate for Payer: Central Health Plan Commercial |
$23,688.00
|
| Rate for Payer: Cigna of CA HMO |
$20,727.00
|
| Rate for Payer: Cigna of CA PPO |
$20,727.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,844.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,844.00
|
| Rate for Payer: Galaxy Health WC |
$25,168.50
|
| Rate for Payer: Global Benefits Group Commercial |
$17,766.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,649.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,749.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,281.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,328.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,922.00
|
| Rate for Payer: Multiplan Commercial |
$22,207.50
|
| Rate for Payer: Networks By Design Commercial |
$14,805.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,168.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,112.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10,816.53
|
| Rate for Payer: United Healthcare HMO Rider |
$10,582.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,697.27
|
|
|
HC DFIB B/S COGNIS 100-D N119
|
Facility
|
OP
|
$29,610.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,922.00 |
| Max. Negotiated Rate |
$26,649.00 |
| Rate for Payer: Adventist Health Commercial |
$5,922.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,285.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,207.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,519.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,395.06
|
| Rate for Payer: Blue Shield of California Commercial |
$22,888.53
|
| Rate for Payer: Blue Shield of California EPN |
$14,923.44
|
| Rate for Payer: Cash Price |
$16,285.50
|
| Rate for Payer: Central Health Plan Commercial |
$23,688.00
|
| Rate for Payer: Cigna of CA HMO |
$20,727.00
|
| Rate for Payer: Cigna of CA PPO |
$20,727.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,168.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,168.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,844.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11,844.00
|
| Rate for Payer: Galaxy Health WC |
$25,168.50
|
| Rate for Payer: Global Benefits Group Commercial |
$17,766.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,649.00
|
| Rate for Payer: InnovAge PACE Commercial |
$14,805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,749.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,328.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,922.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,727.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,727.00
|
| Rate for Payer: Multiplan Commercial |
$22,207.50
|
| Rate for Payer: Networks By Design Commercial |
$14,805.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,168.50
|
| Rate for Payer: Riverside University Health System MISP |
$11,844.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,766.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,766.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,112.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10,816.53
|
| Rate for Payer: United Healthcare HMO Rider |
$10,582.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,697.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,168.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,168.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25,168.50
|
|
|
HC DFIB B/S CONFIENT E030
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,415.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC DFIB B/S CONFIENT E030
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
906813596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC DFIB B/S DYNAGEN CRT-D G154
|
Facility
|
IP
|
$30,210.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,042.00 |
| Max. Negotiated Rate |
$27,189.00 |
| Rate for Payer: Adventist Health Commercial |
$6,042.00
|
| Rate for Payer: Blue Shield of California Commercial |
$23,352.33
|
| Rate for Payer: Blue Shield of California EPN |
$15,225.84
|
| Rate for Payer: Cash Price |
$16,615.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,168.00
|
| Rate for Payer: Cigna of CA HMO |
$21,147.00
|
| Rate for Payer: Cigna of CA PPO |
$21,147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,084.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,084.00
|
| Rate for Payer: Galaxy Health WC |
$25,678.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,150.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,510.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,699.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,042.00
|
| Rate for Payer: Multiplan Commercial |
$22,657.50
|
| Rate for Payer: Networks By Design Commercial |
$15,105.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,678.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,337.81
|
| Rate for Payer: United Healthcare All Other HMO |
$11,035.71
|
| Rate for Payer: United Healthcare HMO Rider |
$10,797.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,893.77
|
|
|
HC DFIB B/S DYNAGEN CRT-D G154
|
Facility
|
OP
|
$30,210.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,042.00 |
| Max. Negotiated Rate |
$27,189.00 |
| Rate for Payer: Adventist Health Commercial |
$6,042.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,678.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,615.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,657.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,793.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,727.28
|
| Rate for Payer: Blue Shield of California Commercial |
$23,352.33
|
| Rate for Payer: Blue Shield of California EPN |
$15,225.84
|
| Rate for Payer: Cash Price |
$16,615.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,168.00
|
| Rate for Payer: Cigna of CA HMO |
$21,147.00
|
| Rate for Payer: Cigna of CA PPO |
$21,147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,678.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,678.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,678.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,084.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,084.00
|
| Rate for Payer: Galaxy Health WC |
$25,678.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,189.00
|
| Rate for Payer: InnovAge PACE Commercial |
$15,105.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,150.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,699.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,042.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,147.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,147.00
|
| Rate for Payer: Multiplan Commercial |
$22,657.50
|
| Rate for Payer: Networks By Design Commercial |
$15,105.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,678.50
|
| Rate for Payer: Riverside University Health System MISP |
$12,084.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,337.81
|
| Rate for Payer: United Healthcare All Other HMO |
$11,035.71
|
| Rate for Payer: United Healthcare HMO Rider |
$10,797.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,893.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,678.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,678.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25,678.50
|
|
|
HC DFIB B/S DYNAGEN CRT G150
|
Facility
|
OP
|
$20,340.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,068.00 |
| Max. Negotiated Rate |
$18,306.00 |
| Rate for Payer: Adventist Health Commercial |
$4,068.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,289.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,187.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,255.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,287.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,262.26
|
| Rate for Payer: Blue Shield of California Commercial |
$15,722.82
|
| Rate for Payer: Blue Shield of California EPN |
$10,251.36
|
| Rate for Payer: Cash Price |
$11,187.00
|
| Rate for Payer: Central Health Plan Commercial |
$16,272.00
|
| Rate for Payer: Cigna of CA HMO |
$14,238.00
|
| Rate for Payer: Cigna of CA PPO |
$14,238.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,289.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,289.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,289.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,136.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,136.00
|
| Rate for Payer: Galaxy Health WC |
$17,289.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12,204.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,306.00
|
| Rate for Payer: InnovAge PACE Commercial |
$10,170.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,566.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,590.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,068.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,238.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,238.00
|
| Rate for Payer: Multiplan Commercial |
$15,255.00
|
| Rate for Payer: Networks By Design Commercial |
$10,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$17,289.00
|
| Rate for Payer: Riverside University Health System MISP |
$8,136.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,204.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,204.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,633.60
|
| Rate for Payer: United Healthcare All Other HMO |
$7,430.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7,269.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,661.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,289.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,289.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17,289.00
|
|
|
HC DFIB B/S DYNAGEN CRT G150
|
Facility
|
IP
|
$20,340.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,068.00 |
| Max. Negotiated Rate |
$18,306.00 |
| Rate for Payer: Adventist Health Commercial |
$4,068.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15,722.82
|
| Rate for Payer: Blue Shield of California EPN |
$10,251.36
|
| Rate for Payer: Cash Price |
$11,187.00
|
| Rate for Payer: Central Health Plan Commercial |
$16,272.00
|
| Rate for Payer: Cigna of CA HMO |
$14,238.00
|
| Rate for Payer: Cigna of CA PPO |
$14,238.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,136.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,136.00
|
| Rate for Payer: Galaxy Health WC |
$17,289.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12,204.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,306.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,566.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,749.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,590.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,068.00
|
| Rate for Payer: Multiplan Commercial |
$15,255.00
|
| Rate for Payer: Networks By Design Commercial |
$10,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$17,289.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,633.60
|
| Rate for Payer: United Healthcare All Other HMO |
$7,430.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7,269.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,661.35
|
|
|
HC DFIB B/S DYNAGEN EL DR VR D151
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
906813751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
|
|
HC DFIB B/S DYNAGEN EL DR VR D151
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
906813751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,415.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19,325.00
|
| Rate for Payer: Blue Shield of California EPN |
$12,600.00
|
| Rate for Payer: Cash Price |
$13,750.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,935.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,187.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC DFIB B/S DYNAGEN X4CRT G156
|
Facility
|
IP
|
$30,510.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,102.00 |
| Max. Negotiated Rate |
$27,459.00 |
| Rate for Payer: Adventist Health Commercial |
$6,102.00
|
| Rate for Payer: Blue Shield of California Commercial |
$23,584.23
|
| Rate for Payer: Blue Shield of California EPN |
$15,377.04
|
| Rate for Payer: Cash Price |
$16,780.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,408.00
|
| Rate for Payer: Cigna of CA HMO |
$21,357.00
|
| Rate for Payer: Cigna of CA PPO |
$21,357.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,204.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,204.00
|
| Rate for Payer: Galaxy Health WC |
$25,933.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,306.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,459.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,350.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,624.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,885.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,102.00
|
| Rate for Payer: Multiplan Commercial |
$22,882.50
|
| Rate for Payer: Networks By Design Commercial |
$15,255.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,933.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,450.40
|
| Rate for Payer: United Healthcare All Other HMO |
$11,145.30
|
| Rate for Payer: United Healthcare HMO Rider |
$10,904.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,992.02
|
|
|
HC DFIB B/S DYNAGEN X4CRT G156
|
Facility
|
OP
|
$30,510.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,102.00 |
| Max. Negotiated Rate |
$27,459.00 |
| Rate for Payer: Adventist Health Commercial |
$6,102.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,780.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,882.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,930.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,893.39
|
| Rate for Payer: Blue Shield of California Commercial |
$23,584.23
|
| Rate for Payer: Blue Shield of California EPN |
$15,377.04
|
| Rate for Payer: Cash Price |
$16,780.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,408.00
|
| Rate for Payer: Cigna of CA HMO |
$21,357.00
|
| Rate for Payer: Cigna of CA PPO |
$21,357.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,933.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,933.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,204.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,204.00
|
| Rate for Payer: Galaxy Health WC |
$25,933.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,306.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,459.00
|
| Rate for Payer: InnovAge PACE Commercial |
$15,255.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,350.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,885.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,102.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,357.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,357.00
|
| Rate for Payer: Multiplan Commercial |
$22,882.50
|
| Rate for Payer: Networks By Design Commercial |
$15,255.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,933.50
|
| Rate for Payer: Riverside University Health System MISP |
$12,204.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,306.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,306.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,450.40
|
| Rate for Payer: United Healthcare All Other HMO |
$11,145.30
|
| Rate for Payer: United Healthcare HMO Rider |
$10,904.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,992.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,933.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25,933.50
|
|
|
HC DFIB B/S DYNAGEN X4 CRT G158
|
Facility
|
OP
|
$30,510.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,102.00 |
| Max. Negotiated Rate |
$27,459.00 |
| Rate for Payer: Adventist Health Commercial |
$6,102.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,780.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,882.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,930.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,893.39
|
| Rate for Payer: Blue Shield of California Commercial |
$23,584.23
|
| Rate for Payer: Blue Shield of California EPN |
$15,377.04
|
| Rate for Payer: Cash Price |
$16,780.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,408.00
|
| Rate for Payer: Cigna of CA HMO |
$21,357.00
|
| Rate for Payer: Cigna of CA PPO |
$21,357.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,933.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,933.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,204.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,204.00
|
| Rate for Payer: Galaxy Health WC |
$25,933.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,306.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,459.00
|
| Rate for Payer: InnovAge PACE Commercial |
$15,255.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,350.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,885.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,102.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,357.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,357.00
|
| Rate for Payer: Multiplan Commercial |
$22,882.50
|
| Rate for Payer: Networks By Design Commercial |
$15,255.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,933.50
|
| Rate for Payer: Riverside University Health System MISP |
$12,204.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,306.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,306.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,450.40
|
| Rate for Payer: United Healthcare All Other HMO |
$11,145.30
|
| Rate for Payer: United Healthcare HMO Rider |
$10,904.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,992.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,933.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,933.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25,933.50
|
|
|
HC DFIB B/S DYNAGEN X4 CRT G158
|
Facility
|
IP
|
$30,510.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
906813749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,102.00 |
| Max. Negotiated Rate |
$27,459.00 |
| Rate for Payer: Adventist Health Commercial |
$6,102.00
|
| Rate for Payer: Blue Shield of California Commercial |
$23,584.23
|
| Rate for Payer: Blue Shield of California EPN |
$15,377.04
|
| Rate for Payer: Cash Price |
$16,780.50
|
| Rate for Payer: Central Health Plan Commercial |
$24,408.00
|
| Rate for Payer: Cigna of CA HMO |
$21,357.00
|
| Rate for Payer: Cigna of CA PPO |
$21,357.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,204.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,204.00
|
| Rate for Payer: Galaxy Health WC |
$25,933.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,306.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,459.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,350.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,624.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,885.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,102.00
|
| Rate for Payer: Multiplan Commercial |
$22,882.50
|
| Rate for Payer: Networks By Design Commercial |
$15,255.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,933.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,450.40
|
| Rate for Payer: United Healthcare All Other HMO |
$11,145.30
|
| Rate for Payer: United Healthcare HMO Rider |
$10,904.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,992.02
|
|
|
HC DFIB B/S EMBLEM A209
|
Facility
|
IP
|
$31,500.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
906813755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,300.00 |
| Max. Negotiated Rate |
$28,350.00 |
| Rate for Payer: Adventist Health Commercial |
$6,300.00
|
| Rate for Payer: Blue Shield of California Commercial |
$24,349.50
|
| Rate for Payer: Blue Shield of California EPN |
$15,876.00
|
| Rate for Payer: Cash Price |
$17,325.00
|
| Rate for Payer: Central Health Plan Commercial |
$25,200.00
|
| Rate for Payer: Cigna of CA HMO |
$22,050.00
|
| Rate for Payer: Cigna of CA PPO |
$22,050.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,600.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,600.00
|
| Rate for Payer: Galaxy Health WC |
$26,775.00
|
| Rate for Payer: Global Benefits Group Commercial |
$18,900.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,350.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,010.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,001.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,498.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,300.00
|
| Rate for Payer: Multiplan Commercial |
$23,625.00
|
| Rate for Payer: Networks By Design Commercial |
$15,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,775.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,821.95
|
| Rate for Payer: United Healthcare All Other HMO |
$11,506.95
|
| Rate for Payer: United Healthcare HMO Rider |
$11,258.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,316.25
|
|
