|
HC EPS ARTERIAL CATH SET
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC EPS ARTERIAL CATH SET
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.53
|
| Rate for Payer: Blue Shield of California Commercial |
$182.59
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC EPS ATRIAL PACING
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$182.11 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$370.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Cigna of CA HMO |
$3,185.92
|
| Rate for Payer: Cigna of CA PPO |
$3,683.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,986.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,986.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS ATRIAL PACING
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,991.20
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,937.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,991.20
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,937.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$182.11 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$303.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Cigna of CA HMO |
$3,185.92
|
| Rate for Payer: Cigna of CA PPO |
$3,683.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,986.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,986.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$6,854.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$281.13 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,370.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$522.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,483.20
|
| Rate for Payer: Cigna of CA HMO |
$4,386.56
|
| Rate for Payer: Cigna of CA PPO |
$5,071.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,797.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$5,825.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,112.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,168.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$281.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,352.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$310.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,370.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$5,140.50
|
| Rate for Payer: Networks By Design Commercial |
$4,455.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$5,825.90
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,112.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,112.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$6,854.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,370.80 |
| Max. Negotiated Rate |
$6,168.60 |
| Rate for Payer: Adventist Health Commercial |
$1,370.80
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,483.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,797.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,741.60
|
| Rate for Payer: Galaxy Health WC |
$5,825.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,112.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,168.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,352.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,043.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,370.80
|
| Rate for Payer: Multiplan Commercial |
$5,140.50
|
| Rate for Payer: Networks By Design Commercial |
$4,455.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,825.90
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
IP
|
$8,841.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,768.20 |
| Max. Negotiated Rate |
$7,956.90 |
| Rate for Payer: Adventist Health Commercial |
$1,768.20
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,072.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,188.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,536.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,536.40
|
| Rate for Payer: Galaxy Health WC |
$7,514.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,304.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,956.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,614.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,216.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,768.20
|
| Rate for Payer: Multiplan Commercial |
$6,630.75
|
| Rate for Payer: Networks By Design Commercial |
$5,746.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,514.85
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
OP
|
$8,841.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,768.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,493.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,072.80
|
| Rate for Payer: Cigna of CA HMO |
$5,658.24
|
| Rate for Payer: Cigna of CA PPO |
$6,542.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,188.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$7,514.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,304.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,956.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,231.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,614.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,359.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,768.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$6,630.75
|
| Rate for Payer: Networks By Design Commercial |
$5,746.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$7,514.85
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,304.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,304.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$31,071.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$27,963.90 |
| Rate for Payer: Adventist Health Commercial |
$6,214.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,437.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$13,981.95
|
| Rate for Payer: Cash Price |
$13,981.95
|
| Rate for Payer: Cash Price |
$13,981.95
|
| Rate for Payer: Cash Price |
$13,981.95
|
| Rate for Payer: Central Health Plan Commercial |
$24,856.80
|
| Rate for Payer: Cigna of CA HMO |
$19,885.44
|
| Rate for Payer: Cigna of CA PPO |
$22,992.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,749.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$26,410.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18,642.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,963.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,730.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,214.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$23,303.25
|
| Rate for Payer: Networks By Design Commercial |
$20,196.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$26,410.35
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,642.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$31,071.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,214.20 |
| Max. Negotiated Rate |
$27,963.90 |
| Rate for Payer: Adventist Health Commercial |
$6,214.20
|
| Rate for Payer: Cash Price |
$13,981.95
|
| Rate for Payer: Central Health Plan Commercial |
$24,856.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,749.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,428.40
|
| Rate for Payer: EPIC Health Plan Senior |
$12,428.40
|
| Rate for Payer: Galaxy Health WC |
$26,410.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18,642.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,963.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,730.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,331.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,214.20
|
| Rate for Payer: Multiplan Commercial |
$23,303.25
|
| Rate for Payer: Networks By Design Commercial |
$20,196.15
|
| Rate for Payer: Prime Health Services Commercial |
$26,410.35
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$22,085.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,417.00 |
| Max. Negotiated Rate |
$19,876.50 |
| Rate for Payer: Adventist Health Commercial |
$4,417.00
|
| Rate for Payer: Cash Price |
$9,938.25
|
| Rate for Payer: Central Health Plan Commercial |
$17,668.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,459.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,834.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,834.00
|
| Rate for Payer: Galaxy Health WC |
$18,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,876.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,023.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,030.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,417.00
|
| Rate for Payer: Multiplan Commercial |
$16,563.75
|
| Rate for Payer: Networks By Design Commercial |
$14,355.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,772.25
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$22,085.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$19,876.50 |
| Rate for Payer: Adventist Health Commercial |
$4,417.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,031.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,060.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$9,938.25
|
| Rate for Payer: Cash Price |
$9,938.25
|
| Rate for Payer: Cash Price |
$9,938.25
|
| Rate for Payer: Cash Price |
$9,938.25
|
| Rate for Payer: Central Health Plan Commercial |
$17,668.00
|
| Rate for Payer: Cigna of CA HMO |
$14,134.40
|
| Rate for Payer: Cigna of CA PPO |
$16,342.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,459.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$18,772.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,251.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,876.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,025.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,023.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,133.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,417.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$16,563.75
|
| Rate for Payer: Networks By Design Commercial |
$14,355.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Prime Health Services Commercial |
$18,772.25
|
| Rate for Payer: Prime Health Services Medicare |
$10,633.57
|
| Rate for Payer: Riverside University Health System MISP |
$11,034.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,251.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,251.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
IP
|
$47,331.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,466.20 |
| Max. Negotiated Rate |
$42,597.90 |
| Rate for Payer: Adventist Health Commercial |
$9,466.20
|
| Rate for Payer: Cash Price |
$21,298.95
|
| Rate for Payer: Central Health Plan Commercial |
$37,864.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33,131.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,932.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18,932.40
|
| Rate for Payer: Galaxy Health WC |
$40,231.35
|
| Rate for Payer: Global Benefits Group Commercial |
$28,398.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,597.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30,055.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,925.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,466.20
|
| Rate for Payer: Multiplan Commercial |
$35,498.25
|
| Rate for Payer: Networks By Design Commercial |
$30,765.15
|
| Rate for Payer: Prime Health Services Commercial |
$40,231.35
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
OP
|
$47,331.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,514.41 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$9,466.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$33,617.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$21,298.95
|
| Rate for Payer: Cash Price |
$21,298.95
|
| Rate for Payer: Cash Price |
$21,298.95
|
| Rate for Payer: Central Health Plan Commercial |
$37,864.80
|
| Rate for Payer: Cigna of CA HMO |
$30,765.15
|
| Rate for Payer: Cigna of CA PPO |
$35,024.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33,131.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$40,231.35
|
| Rate for Payer: Global Benefits Group Commercial |
$28,398.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,597.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,514.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30,055.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,672.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,466.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$35,498.25
|
| Rate for Payer: Networks By Design Commercial |
$30,765.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Prime Health Services Commercial |
$40,231.35
|
| Rate for Payer: Prime Health Services Medicare |
$35,634.71
|
| Rate for Payer: Riverside University Health System MISP |
$36,979.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,398.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28,398.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,665.50
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
OP
|
$33,365.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,134.27 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$6,673.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$33,617.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$15,014.25
|
| Rate for Payer: Cash Price |
$15,014.25
|
| Rate for Payer: Cash Price |
$15,014.25
|
| Rate for Payer: Central Health Plan Commercial |
$26,692.00
|
| Rate for Payer: Cigna of CA HMO |
$21,687.25
|
| Rate for Payer: Cigna of CA PPO |
$24,690.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23,355.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$28,360.25
|
| Rate for Payer: Global Benefits Group Commercial |
$20,019.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,028.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,134.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21,186.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,673.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$25,023.75
|
| Rate for Payer: Networks By Design Commercial |
$21,687.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Prime Health Services Commercial |
$28,360.25
|
| Rate for Payer: Prime Health Services Medicare |
$35,634.71
|
| Rate for Payer: Riverside University Health System MISP |
$36,979.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,019.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20,019.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,682.50
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$33,365.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,673.00 |
| Max. Negotiated Rate |
$30,028.50 |
| Rate for Payer: Adventist Health Commercial |
$6,673.00
|
| Rate for Payer: Cash Price |
$15,014.25
|
| Rate for Payer: Central Health Plan Commercial |
$26,692.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23,355.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,346.00
|
| Rate for Payer: EPIC Health Plan Senior |
$13,346.00
|
| Rate for Payer: Galaxy Health WC |
$28,360.25
|
| Rate for Payer: Global Benefits Group Commercial |
$20,019.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,028.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21,186.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,685.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,673.00
|
| Rate for Payer: Multiplan Commercial |
$25,023.75
|
| Rate for Payer: Networks By Design Commercial |
$21,687.25
|
| Rate for Payer: Prime Health Services Commercial |
$28,360.25
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$31,064.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,212.80 |
| Max. Negotiated Rate |
$27,957.60 |
| Rate for Payer: Adventist Health Commercial |
$6,212.80
|
| Rate for Payer: Cash Price |
$13,978.80
|
| Rate for Payer: Central Health Plan Commercial |
$24,851.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,744.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,425.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,425.60
|
| Rate for Payer: Galaxy Health WC |
$26,404.40
|
| Rate for Payer: Global Benefits Group Commercial |
$18,638.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,957.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,725.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,327.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,212.80
|
| Rate for Payer: Multiplan Commercial |
$23,298.00
|
| Rate for Payer: Networks By Design Commercial |
$20,191.60
|
| Rate for Payer: Prime Health Services Commercial |
$26,404.40
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$31,064.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,513.98 |
| Max. Negotiated Rate |
$55,469.12 |
| Rate for Payer: Adventist Health Commercial |
$6,212.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$33,617.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$13,978.80
|
| Rate for Payer: Cash Price |
$13,978.80
|
| Rate for Payer: Cash Price |
$13,978.80
|
| Rate for Payer: Central Health Plan Commercial |
$24,851.20
|
| Rate for Payer: Cigna of CA HMO |
$20,191.60
|
| Rate for Payer: Cigna of CA PPO |
$22,987.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,744.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,469.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,979.42
|
| Rate for Payer: Galaxy Health WC |
$26,404.40
|
| Rate for Payer: Global Benefits Group Commercial |
$18,638.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,957.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55,132.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,513.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,725.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,064.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,212.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$23,298.00
|
| Rate for Payer: Networks By Design Commercial |
$20,191.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Prime Health Services Commercial |
$26,404.40
|
| Rate for Payer: Prime Health Services Medicare |
$35,634.71
|
| Rate for Payer: Riverside University Health System MISP |
$36,979.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,638.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,638.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,532.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$33,617.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,991.20
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,937.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$86.70 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,565.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$86.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Cigna of CA HMO |
$3,185.92
|
| Rate for Payer: Cigna of CA PPO |
$3,683.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$141.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,659.92
|
| Rate for Payer: Riverside University Health System MISP |
$1,722.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,986.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,986.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,991.20
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,937.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$143.33 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,565.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$143.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Cigna of CA HMO |
$3,185.92
|
| Rate for Payer: Cigna of CA PPO |
$3,683.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,484.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$160.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,161.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,659.92
|
| Rate for Payer: Riverside University Health System MISP |
$1,722.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,986.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,986.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$14,021.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,804.20 |
| Max. Negotiated Rate |
$12,618.90 |
| Rate for Payer: Adventist Health Commercial |
$2,804.20
|
| Rate for Payer: Cash Price |
$6,309.45
|
| Rate for Payer: Central Health Plan Commercial |
$11,216.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,814.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,608.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,608.40
|
| Rate for Payer: Galaxy Health WC |
$11,917.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,412.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,618.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,903.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,272.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,804.20
|
| Rate for Payer: Multiplan Commercial |
$10,515.75
|
| Rate for Payer: Networks By Design Commercial |
$9,113.65
|
| Rate for Payer: Prime Health Services Commercial |
$11,917.85
|
|
