|
HC EP RF BIO/WEB COOL FLOW TUBING
|
Facility
|
OP
|
$481.00
|
|
| Hospital Charge Code |
906812736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$292.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$360.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$232.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.49
|
| Rate for Payer: Blue Shield of California Commercial |
$293.89
|
| Rate for Payer: Blue Shield of California EPN |
$191.92
|
| Rate for Payer: Cash Price |
$264.55
|
| Rate for Payer: Central Health Plan Commercial |
$384.80
|
| Rate for Payer: Cigna of CA HMO |
$307.84
|
| Rate for Payer: Cigna of CA PPO |
$355.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$408.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$408.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Senior |
$192.40
|
| Rate for Payer: Galaxy Health WC |
$408.85
|
| Rate for Payer: Global Benefits Group Commercial |
$288.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$432.90
|
| Rate for Payer: InnovAge PACE Commercial |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$320.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$336.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$336.70
|
| Rate for Payer: Multiplan Commercial |
$360.75
|
| Rate for Payer: Networks By Design Commercial |
$312.65
|
| Rate for Payer: Prime Health Services Commercial |
$408.85
|
| Rate for Payer: Riverside University Health System MISP |
$192.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.50
|
| Rate for Payer: United Healthcare All Other HMO |
$240.50
|
| Rate for Payer: United Healthcare HMO Rider |
$240.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$408.85
|
| Rate for Payer: Vantage Medical Group Senior |
$408.85
|
|
|
HC EP RF BIO WEB EZ STEER THERMOC
|
Facility
|
OP
|
$3,913.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$782.60 |
| Max. Negotiated Rate |
$3,521.70 |
| Rate for Payer: Adventist Health Commercial |
$782.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,326.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,152.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,934.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,166.63
|
| Rate for Payer: Blue Shield of California Commercial |
$3,024.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,972.15
|
| Rate for Payer: Cash Price |
$2,152.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,130.40
|
| Rate for Payer: Cigna of CA HMO |
$2,739.10
|
| Rate for Payer: Cigna of CA PPO |
$2,739.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,326.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,326.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,326.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,565.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,565.20
|
| Rate for Payer: Galaxy Health WC |
$3,326.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,347.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,521.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,956.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,609.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,490.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,422.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$782.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,739.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,739.10
|
| Rate for Payer: Multiplan Commercial |
$2,934.75
|
| Rate for Payer: Networks By Design Commercial |
$1,956.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,326.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,565.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,347.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,347.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,468.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,429.42
|
| Rate for Payer: United Healthcare HMO Rider |
$1,398.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,281.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,326.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,326.05
|
| Rate for Payer: Vantage Medical Group Senior |
$3,326.05
|
|
|
HC EP RF BIO WEB EZ STEER THERMOC
|
Facility
|
IP
|
$3,913.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$782.60 |
| Max. Negotiated Rate |
$3,521.70 |
| Rate for Payer: Adventist Health Commercial |
$782.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,024.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,972.15
|
| Rate for Payer: Cash Price |
$2,152.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,130.40
|
| Rate for Payer: Cigna of CA HMO |
$2,739.10
|
| Rate for Payer: Cigna of CA PPO |
$2,739.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,565.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,565.20
|
| Rate for Payer: Galaxy Health WC |
$3,326.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,347.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,521.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,609.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,490.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,422.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$782.60
|
| Rate for Payer: Multiplan Commercial |
$2,934.75
|
| Rate for Payer: Networks By Design Commercial |
$1,956.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,326.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,468.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,429.42
|
| Rate for Payer: United Healthcare HMO Rider |
$1,398.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,281.51
|
|
|
HC EP RF CRYO ARCTIC FRONT ADVANCE
|
Facility
|
IP
|
$11,625.00
|
|
|
Service Code
|
CPT C1733
|
| Hospital Charge Code |
906812541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,325.00 |
| Max. Negotiated Rate |
$10,462.50 |
| Rate for Payer: Adventist Health Commercial |
$2,325.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,986.12
|
| Rate for Payer: Blue Shield of California EPN |
$5,859.00
|
| Rate for Payer: Cash Price |
$6,393.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,300.00
|
| Rate for Payer: Cigna of CA HMO |
$8,137.50
|
| Rate for Payer: Cigna of CA PPO |
$8,137.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,650.00
|
| Rate for Payer: Galaxy Health WC |
$9,881.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,975.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,462.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,753.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,429.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,195.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,325.00
|
| Rate for Payer: Multiplan Commercial |
$8,718.75
|
| Rate for Payer: Networks By Design Commercial |
$5,812.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,881.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,362.86
|
| Rate for Payer: United Healthcare All Other HMO |
$4,246.61
|
| Rate for Payer: United Healthcare HMO Rider |
$4,154.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,807.19
|
|
|
HC EP RF CRYO ARCTIC FRONT ADVANCE
|
Facility
|
OP
|
$11,625.00
|
|
|
Service Code
|
CPT C1733
|
| Hospital Charge Code |
906812541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,325.00 |
| Max. Negotiated Rate |
$10,462.50 |
| Rate for Payer: Adventist Health Commercial |
$2,325.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,881.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,393.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,718.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,307.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,436.76
|
| Rate for Payer: Blue Shield of California Commercial |
$8,986.12
|
| Rate for Payer: Blue Shield of California EPN |
$5,859.00
|
| Rate for Payer: Cash Price |
$6,393.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,300.00
|
| Rate for Payer: Cigna of CA HMO |
$8,137.50
|
| Rate for Payer: Cigna of CA PPO |
$8,137.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,881.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,881.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,881.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,650.00
|
| Rate for Payer: Galaxy Health WC |
$9,881.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,975.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,462.50
|
| Rate for Payer: InnovAge PACE Commercial |
$5,812.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,753.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,429.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,195.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,325.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,137.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,137.50
|
| Rate for Payer: Multiplan Commercial |
$8,718.75
|
| Rate for Payer: Networks By Design Commercial |
$5,812.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,881.25
|
| Rate for Payer: Riverside University Health System MISP |
$4,650.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,975.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,975.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,362.86
|
| Rate for Payer: United Healthcare All Other HMO |
$4,246.61
|
| Rate for Payer: United Healthcare HMO Rider |
$4,154.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,807.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,881.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,881.25
|
| Rate for Payer: Vantage Medical Group Senior |
$9,881.25
|
|
|
HC EP RF CRYO CO-AXIAL TUBING
|
Facility
|
OP
|
$418.00
|
|
| Hospital Charge Code |
906812330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$253.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.49
|
| Rate for Payer: Blue Shield of California Commercial |
$255.40
|
| Rate for Payer: Blue Shield of California EPN |
$166.78
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Central Health Plan Commercial |
$334.40
|
| Rate for Payer: Cigna of CA HMO |
$267.52
|
| Rate for Payer: Cigna of CA PPO |
$309.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$355.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$355.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Senior |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$376.20
|
| Rate for Payer: InnovAge PACE Commercial |
$209.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$278.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$258.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$292.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$292.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: Networks By Design Commercial |
$271.70
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
| Rate for Payer: Riverside University Health System MISP |
$167.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.00
|
| Rate for Payer: United Healthcare All Other HMO |
$209.00
|
| Rate for Payer: United Healthcare HMO Rider |
$209.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$355.30
|
| Rate for Payer: Vantage Medical Group Senior |
$355.30
|
|
|
HC EP RF CRYO CO-AXIAL TUBING
|
Facility
|
IP
|
$418.00
|
|
| Hospital Charge Code |
906812330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Central Health Plan Commercial |
$334.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Senior |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$376.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$278.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$258.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: Networks By Design Commercial |
$271.70
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
|
|
HC EP RF STJ ENSIT VELOCITY PATCH
|
Facility
|
IP
|
$3,347.00
|
|
|
Service Code
|
CPT C1732
|
| Hospital Charge Code |
906812548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$669.40 |
| Max. Negotiated Rate |
$3,012.30 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,587.23
|
| Rate for Payer: Blue Shield of California EPN |
$1,686.89
|
| Rate for Payer: Cash Price |
$1,840.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,677.60
|
| Rate for Payer: Cigna of CA HMO |
$2,342.90
|
| Rate for Payer: Cigna of CA PPO |
$2,342.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,338.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,338.80
|
| Rate for Payer: Galaxy Health WC |
$2,844.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,008.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,012.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,232.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,275.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,071.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$669.40
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
| Rate for Payer: Networks By Design Commercial |
$1,673.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,844.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,256.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,222.66
|
| Rate for Payer: United Healthcare HMO Rider |
$1,196.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,096.14
|
|
|
HC EP RF STJ ENSIT VELOCITY PATCH
|
Facility
|
OP
|
$3,347.00
|
|
|
Service Code
|
CPT C1732
|
| Hospital Charge Code |
906812548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$669.40 |
| Max. Negotiated Rate |
$3,012.30 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,844.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,840.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,510.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,528.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,853.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,587.23
|
| Rate for Payer: Blue Shield of California EPN |
$1,686.89
|
| Rate for Payer: Cash Price |
$1,840.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,677.60
|
| Rate for Payer: Cigna of CA HMO |
$2,342.90
|
| Rate for Payer: Cigna of CA PPO |
$2,342.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,844.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,844.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,844.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,338.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,338.80
|
| Rate for Payer: Galaxy Health WC |
$2,844.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,008.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,012.30
|
| Rate for Payer: InnovAge PACE Commercial |
$1,673.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,232.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,275.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,071.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$669.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,342.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,342.90
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
| Rate for Payer: Networks By Design Commercial |
$1,673.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,844.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,338.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,008.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,008.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,256.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,222.66
|
| Rate for Payer: United Healthcare HMO Rider |
$1,196.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,096.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,844.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,844.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,844.95
|
|
|
HC EP RF ST J FLEXABILITY D-F
|
Facility
|
OP
|
$4,125.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812639
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,505.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,268.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,093.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,997.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,422.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2,520.38
|
| Rate for Payer: Blue Shield of California EPN |
$1,645.88
|
| Rate for Payer: Cash Price |
$2,268.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: Cigna of CA HMO |
$2,640.00
|
| Rate for Payer: Cigna of CA PPO |
$3,052.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,506.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,506.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,062.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,751.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,571.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,553.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,887.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,887.50
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,650.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,475.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,475.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,062.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,062.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,062.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,062.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,506.25
|
|
|
HC EP RF ST J FLEXABILITY D-F
|
Facility
|
IP
|
$4,125.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812639
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Cash Price |
$2,268.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,751.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,571.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,553.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
|
|
HC EP RF ST J FLEXABILITY F-J
|
Facility
|
OP
|
$4,125.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812638
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,505.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,268.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,093.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,997.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,422.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2,520.38
|
| Rate for Payer: Blue Shield of California EPN |
$1,645.88
|
| Rate for Payer: Cash Price |
$2,268.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: Cigna of CA HMO |
$2,640.00
|
| Rate for Payer: Cigna of CA PPO |
$3,052.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,506.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,506.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,062.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,751.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,571.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,553.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,887.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,887.50
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,650.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,475.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,475.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,062.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,062.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,062.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,062.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,506.25
|
|
|
HC EP RF ST J FLEXABILITY F-J
|
Facility
|
IP
|
$4,125.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812638
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Cash Price |
$2,268.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,751.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,571.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,553.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
|
|
HC EP RF STJ SAFIRE ABLAT CATH
|
Facility
|
OP
|
$3,198.00
|
|
|
Service Code
|
CPT C1733
|
| Hospital Charge Code |
906812342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$639.60 |
| Max. Negotiated Rate |
$2,878.20 |
| Rate for Payer: Adventist Health Commercial |
$639.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,942.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,718.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,758.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,398.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,548.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,878.19
|
| Rate for Payer: Blue Shield of California Commercial |
$1,953.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,758.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,558.40
|
| Rate for Payer: Cigna of CA HMO |
$2,046.72
|
| Rate for Payer: Cigna of CA PPO |
$2,366.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,718.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,718.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,718.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,279.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,279.20
|
| Rate for Payer: Galaxy Health WC |
$2,718.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,918.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,878.20
|
| Rate for Payer: InnovAge PACE Commercial |
$1,599.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,979.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$639.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,238.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,238.60
|
| Rate for Payer: Multiplan Commercial |
$2,398.50
|
| Rate for Payer: Networks By Design Commercial |
$2,078.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,718.30
|
| Rate for Payer: Riverside University Health System MISP |
$1,279.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,918.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,918.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,599.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,599.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,599.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,599.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,718.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,718.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,718.30
|
|
|
HC EP RF STJ SAFIRE ABLAT CATH
|
Facility
|
IP
|
$3,198.00
|
|
|
Service Code
|
CPT C1733
|
| Hospital Charge Code |
906812342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$639.60 |
| Max. Negotiated Rate |
$2,878.20 |
| Rate for Payer: Adventist Health Commercial |
$639.60
|
| Rate for Payer: Cash Price |
$1,758.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,558.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,279.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,279.20
|
| Rate for Payer: Galaxy Health WC |
$2,718.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,918.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,878.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,979.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$639.60
|
| Rate for Payer: Multiplan Commercial |
$2,398.50
|
| Rate for Payer: Networks By Design Commercial |
$2,078.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,718.30
|
|
|
HC EPS 3-D MAPPING
|
Facility
|
IP
|
$9,846.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
906820081
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,969.20 |
| Max. Negotiated Rate |
$8,861.40 |
| Rate for Payer: Adventist Health Commercial |
$1,969.20
|
| Rate for Payer: Cash Price |
$5,415.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,876.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,938.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,938.40
|
| Rate for Payer: Galaxy Health WC |
$8,369.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,907.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,861.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,567.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,751.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,094.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,969.20
|
| Rate for Payer: Multiplan Commercial |
$7,384.50
|
| Rate for Payer: Networks By Design Commercial |
$6,399.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,369.10
|
|
|
HC EPS 3-D MAPPING
|
Facility
|
OP
|
$8,369.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
906812178
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$537.57 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,673.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,082.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,113.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,602.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,276.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,052.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,915.11
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,602.95
|
| Rate for Payer: Cash Price |
$4,602.95
|
| Rate for Payer: Cash Price |
$4,602.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,695.20
|
| Rate for Payer: Cigna of CA HMO |
$5,356.16
|
| Rate for Payer: Cigna of CA PPO |
$6,193.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,113.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,113.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,113.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,347.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,347.60
|
| Rate for Payer: Galaxy Health WC |
$7,113.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,021.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,532.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$537.57
|
| Rate for Payer: InnovAge PACE Commercial |
$4,184.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,582.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$593.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,180.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,673.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,858.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,858.30
|
| Rate for Payer: Multiplan Commercial |
$6,276.75
|
| Rate for Payer: Networks By Design Commercial |
$5,439.85
|
| Rate for Payer: Prime Health Services Commercial |
$7,113.65
|
| Rate for Payer: Riverside University Health System MISP |
$3,347.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,021.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,021.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$7,113.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,113.65
|
| Rate for Payer: Vantage Medical Group Senior |
$7,113.65
|
|
|
HC EPS 3-D MAPPING
|
Facility
|
IP
|
$8,369.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
906812178
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,673.80 |
| Max. Negotiated Rate |
$7,532.10 |
| Rate for Payer: Adventist Health Commercial |
$1,673.80
|
| Rate for Payer: Cash Price |
$4,602.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,695.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,347.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,347.60
|
| Rate for Payer: Galaxy Health WC |
$7,113.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,021.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,532.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,582.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,188.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,180.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,673.80
|
| Rate for Payer: Multiplan Commercial |
$6,276.75
|
| Rate for Payer: Networks By Design Commercial |
$5,439.85
|
| Rate for Payer: Prime Health Services Commercial |
$7,113.65
|
|
|
HC EPS 3-D MAPPING
|
Facility
|
OP
|
$9,846.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
906820081
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$537.57 |
| Max. Negotiated Rate |
$8,861.40 |
| Rate for Payer: Adventist Health Commercial |
$1,969.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,979.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,369.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,415.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,384.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,767.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,782.56
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,415.30
|
| Rate for Payer: Cash Price |
$5,415.30
|
| Rate for Payer: Cash Price |
$5,415.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,876.80
|
| Rate for Payer: Cigna of CA HMO |
$6,301.44
|
| Rate for Payer: Cigna of CA PPO |
$7,286.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,369.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,369.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,938.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,938.40
|
| Rate for Payer: Galaxy Health WC |
$8,369.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,907.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,861.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$537.57
|
| Rate for Payer: InnovAge PACE Commercial |
$4,923.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,567.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$593.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,094.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,969.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,892.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,892.20
|
| Rate for Payer: Multiplan Commercial |
$7,384.50
|
| Rate for Payer: Networks By Design Commercial |
$6,399.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,369.10
|
| Rate for Payer: Riverside University Health System MISP |
$3,938.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,907.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,907.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$8,369.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,369.10
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906811328
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$304.30 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,542.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,542.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,410.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,923.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| 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 |
$2,313.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,696.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.38
|
| Rate for Payer: EPIC Health Plan Senior |
$1,542.50
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| 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 |
$2,529.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,542.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,313.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,320.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,542.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,066.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,066.95
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,542.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,635.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,696.75
|
| 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 |
$1,542.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.50
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906811328
|
|
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 |
$2,737.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| 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 Permanente of CA Commercial/Self Funded |
$3,320.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,896.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,081.38
|
| 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 ARRHYTHMIA INDUCTION
|
Facility
|
OP
|
$5,856.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906820047
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$304.30 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,171.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,542.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,542.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,835.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,439.23
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,684.80
|
| Rate for Payer: Cigna of CA HMO |
$3,747.84
|
| Rate for Payer: Cigna of CA PPO |
$4,333.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,696.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.38
|
| Rate for Payer: EPIC Health Plan Senior |
$1,542.50
|
| Rate for Payer: Galaxy Health WC |
$4,977.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,513.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,270.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,529.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,542.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,313.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,905.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,542.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,171.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,066.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,066.95
|
| Rate for Payer: Multiplan Commercial |
$4,392.00
|
| Rate for Payer: Networks By Design Commercial |
$3,806.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,542.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,977.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,635.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,696.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,513.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,513.60
|
| 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 |
$1,542.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.50
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
|
IP
|
$5,856.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906820047
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,171.20 |
| Max. Negotiated Rate |
$5,270.40 |
| Rate for Payer: Adventist Health Commercial |
$1,171.20
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,684.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,342.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,342.40
|
| Rate for Payer: Galaxy Health WC |
$4,977.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,513.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,270.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,905.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,231.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,624.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,171.20
|
| Rate for Payer: Multiplan Commercial |
$4,392.00
|
| Rate for Payer: Networks By Design Commercial |
$3,806.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,977.60
|
|
|
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 |
$169.14
|
| Rate for Payer: Blue Shield of California Commercial |
$175.97
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$158.40
|
| 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: 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: InnovAge PACE Commercial |
$144.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA 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 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 |
$158.40
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| 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 Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| 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
|
|
