|
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 |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$1,768.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,280.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,192.32
|
| 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 |
$3,978.45
|
| 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 |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| 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 |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,231.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,896.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,768.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| 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 |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$7,514.85
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$5,896.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,368.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,472.58
|
| 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
|
$10,401.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906820052
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$2,080.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,036.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,108.51
|
| 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 |
$4,680.45
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,320.80
|
| Rate for Payer: Cigna of CA HMO |
$6,656.64
|
| Rate for Payer: Cigna of CA PPO |
$7,696.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| Rate for Payer: Galaxy Health WC |
$8,840.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,360.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,231.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,937.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,080.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| Rate for Payer: Multiplan Commercial |
$7,800.75
|
| Rate for Payer: Networks By Design Commercial |
$6,760.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$8,840.85
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,240.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,240.60
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
IP
|
$10,401.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906820052
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,080.20 |
| Max. Negotiated Rate |
$9,360.90 |
| Rate for Payer: Adventist Health Commercial |
$2,080.20
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,320.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,160.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,160.40
|
| Rate for Payer: Galaxy Health WC |
$8,840.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,360.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,937.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,962.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,438.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,080.20
|
| Rate for Payer: Multiplan Commercial |
$7,800.75
|
| Rate for Payer: Networks By Design Commercial |
$6,760.65
|
| Rate for Payer: Prime Health Services Commercial |
$8,840.85
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$27,018.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906820036
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$24,316.20 |
| Rate for Payer: Adventist Health Commercial |
$5,403.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,082.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,867.67
|
| 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 |
$12,158.10
|
| Rate for Payer: Cash Price |
$12,158.10
|
| Rate for Payer: Cash Price |
$12,158.10
|
| Rate for Payer: Central Health Plan Commercial |
$21,614.40
|
| Rate for Payer: Cigna of CA HMO |
$17,291.52
|
| Rate for Payer: Cigna of CA PPO |
$19,993.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| Rate for Payer: Galaxy Health WC |
$22,965.30
|
| Rate for Payer: Global Benefits Group Commercial |
$16,210.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,316.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,021.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,403.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| Rate for Payer: Multiplan Commercial |
$20,263.50
|
| Rate for Payer: Networks By Design Commercial |
$17,561.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$22,965.30
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,210.80
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$20,724.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,838.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,232.95
|
| 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 ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$27,018.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906820036
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,403.60 |
| Max. Negotiated Rate |
$24,316.20 |
| Rate for Payer: Adventist Health Commercial |
$5,403.60
|
| Rate for Payer: Cash Price |
$12,158.10
|
| Rate for Payer: Central Health Plan Commercial |
$21,614.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,807.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,807.20
|
| Rate for Payer: Galaxy Health WC |
$22,965.30
|
| Rate for Payer: Global Benefits Group Commercial |
$16,210.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,021.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,293.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,724.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,403.60
|
| Rate for Payer: Multiplan Commercial |
$20,263.50
|
| Rate for Payer: Networks By Design Commercial |
$17,561.70
|
| Rate for Payer: Prime Health Services Commercial |
$22,965.30
|
|
|
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 |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,044.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,248.00
|
| 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 |
$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 |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| 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 |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,724.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,214.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| 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 |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$26,410.35
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$19,204.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906820053
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,840.80 |
| Max. Negotiated Rate |
$17,283.60 |
| Rate for Payer: Adventist Health Commercial |
$3,840.80
|
| Rate for Payer: Cash Price |
$8,641.80
|
| Rate for Payer: Central Health Plan Commercial |
$15,363.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,681.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,681.60
|
| Rate for Payer: Galaxy Health WC |
$16,323.40
|
| Rate for Payer: Global Benefits Group Commercial |
$11,522.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,283.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,809.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,316.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,887.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,840.80
|
| Rate for Payer: Multiplan Commercial |
$14,403.00
|
| Rate for Payer: Networks By Design Commercial |
$12,482.60
|
| Rate for Payer: Prime Health Services Commercial |
$16,323.40
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$14,730.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,414.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,670.61
|
| 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
|
$19,204.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906820053
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$17,283.60 |
| Rate for Payer: Adventist Health Commercial |
$3,840.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,298.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,278.51
|
| 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 |
$8,641.80
|
| Rate for Payer: Cash Price |
$8,641.80
|
| Rate for Payer: Cash Price |
$8,641.80
|
| Rate for Payer: Central Health Plan Commercial |
$15,363.20
|
| Rate for Payer: Cigna of CA HMO |
$12,290.56
|
| Rate for Payer: Cigna of CA PPO |
$14,210.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| Rate for Payer: Galaxy Health WC |
$16,323.40
|
| Rate for Payer: Global Benefits Group Commercial |
$11,522.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,283.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,025.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,809.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,840.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| Rate for Payer: Multiplan Commercial |
$14,403.00
|
| Rate for Payer: Networks By Design Commercial |
$12,482.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$16,323.40
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,522.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,522.40
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
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 |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,693.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,970.52
|
| 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 |
$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 |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,015.94
|
| Rate for Payer: EPIC Health Plan Senior |
$9,641.44
|
| 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 |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,025.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14,462.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,730.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,417.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,919.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,919.53
|
| 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 |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$18,772.25
|
| Rate for Payer: Prime Health Services Medicare |
$10,219.93
|
| Rate for Payer: Riverside University Health System MISP |
$10,605.58
|
| 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 |
$9,641.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
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 |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$9,466.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| 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 |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| 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 |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,514.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,466.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| 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 |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$40,231.35
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| 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 |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
IP
|
$55,683.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906820251
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,136.60 |
| Max. Negotiated Rate |
$50,114.70 |
| Rate for Payer: Adventist Health Commercial |
$11,136.60
|
| Rate for Payer: Cash Price |
$25,057.35
|
| Rate for Payer: Central Health Plan Commercial |
$44,546.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,273.20
|
| Rate for Payer: EPIC Health Plan Senior |
$22,273.20
|
| Rate for Payer: Galaxy Health WC |
$47,330.55
|
| Rate for Payer: Global Benefits Group Commercial |
$33,409.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50,114.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,140.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,215.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,467.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,136.60
|
| Rate for Payer: Multiplan Commercial |
$41,762.25
|
| Rate for Payer: Networks By Design Commercial |
$36,193.95
|
| Rate for Payer: Prime Health Services Commercial |
$47,330.55
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
OP
|
$55,683.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906820251
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,514.41 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$11,136.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$25,057.35
|
| Rate for Payer: Cash Price |
$25,057.35
|
| Rate for Payer: Cash Price |
$25,057.35
|
| Rate for Payer: Central Health Plan Commercial |
$44,546.40
|
| Rate for Payer: Cigna of CA HMO |
$36,193.95
|
| Rate for Payer: Cigna of CA PPO |
$41,205.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| Rate for Payer: Galaxy Health WC |
$47,330.55
|
| Rate for Payer: Global Benefits Group Commercial |
$33,409.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50,114.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,514.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,140.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,136.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| Rate for Payer: Multiplan Commercial |
$41,762.25
|
| Rate for Payer: Networks By Design Commercial |
$36,193.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$47,330.55
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33,409.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33,409.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$31,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,033.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,297.89
|
| 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 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: 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 Permanente of CA Commercial/Self Funded |
$22,254.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,712.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,652.94
|
| 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 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 |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$6,673.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| 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 |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| 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 |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,134.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,254.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,673.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| 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 |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$28,360.25
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| 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 |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
OP
|
$39,253.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906820248
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,134.27 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,850.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$17,663.85
|
| Rate for Payer: Cash Price |
$17,663.85
|
| Rate for Payer: Cash Price |
$17,663.85
|
| Rate for Payer: Central Health Plan Commercial |
$31,402.40
|
| Rate for Payer: Cigna of CA HMO |
$25,514.45
|
| Rate for Payer: Cigna of CA PPO |
$29,047.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| Rate for Payer: Galaxy Health WC |
$33,365.05
|
| Rate for Payer: Global Benefits Group Commercial |
$23,551.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$35,327.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,134.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,181.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,850.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| Rate for Payer: Multiplan Commercial |
$29,439.75
|
| Rate for Payer: Networks By Design Commercial |
$25,514.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$33,365.05
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,551.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,551.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$39,253.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906820248
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,850.60 |
| Max. Negotiated Rate |
$35,327.70 |
| Rate for Payer: Adventist Health Commercial |
$7,850.60
|
| Rate for Payer: Cash Price |
$17,663.85
|
| Rate for Payer: Central Health Plan Commercial |
$31,402.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,701.20
|
| Rate for Payer: EPIC Health Plan Senior |
$15,701.20
|
| Rate for Payer: Galaxy Health WC |
$33,365.05
|
| Rate for Payer: Global Benefits Group Commercial |
$23,551.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$35,327.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,181.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,955.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,297.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,850.60
|
| Rate for Payer: Multiplan Commercial |
$29,439.75
|
| Rate for Payer: Networks By Design Commercial |
$25,514.45
|
| Rate for Payer: Prime Health Services Commercial |
$33,365.05
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$36,546.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906820249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,309.20 |
| Max. Negotiated Rate |
$32,891.40 |
| Rate for Payer: Adventist Health Commercial |
$7,309.20
|
| Rate for Payer: Cash Price |
$16,445.70
|
| Rate for Payer: Central Health Plan Commercial |
$29,236.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,618.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14,618.40
|
| Rate for Payer: Galaxy Health WC |
$31,064.10
|
| Rate for Payer: Global Benefits Group Commercial |
$21,927.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32,891.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,376.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,924.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,621.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,309.20
|
| Rate for Payer: Multiplan Commercial |
$27,409.50
|
| Rate for Payer: Networks By Design Commercial |
$23,754.90
|
| Rate for Payer: Prime Health Services Commercial |
$31,064.10
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$20,719.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,228.62
|
| 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 |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$6,212.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| 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 |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| 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 |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,513.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,719.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,212.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| 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 |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$26,404.40
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| 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 |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$36,546.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906820249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,513.98 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,309.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$31,170.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,170.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$16,445.70
|
| Rate for Payer: Cash Price |
$16,445.70
|
| Rate for Payer: Cash Price |
$16,445.70
|
| Rate for Payer: Central Health Plan Commercial |
$29,236.80
|
| Rate for Payer: Cigna of CA HMO |
$23,754.90
|
| Rate for Payer: Cigna of CA PPO |
$27,044.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,287.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,170.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,080.50
|
| Rate for Payer: EPIC Health Plan Senior |
$31,170.74
|
| Rate for Payer: Galaxy Health WC |
$31,064.10
|
| Rate for Payer: Global Benefits Group Commercial |
$21,927.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32,891.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$51,120.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,513.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,170.74
|
| Rate for Payer: InnovAge PACE Commercial |
$46,756.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,376.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,170.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,309.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,768.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,768.79
|
| Rate for Payer: Multiplan Commercial |
$27,409.50
|
| Rate for Payer: Networks By Design Commercial |
$23,754.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31,170.74
|
| Rate for Payer: Prime Health Services Commercial |
$31,064.10
|
| Rate for Payer: Prime Health Services Medicare |
$33,040.98
|
| Rate for Payer: Riverside University Health System MISP |
$34,287.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,927.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,927.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| 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 |
$31,170.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46,756.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,287.81
|
| Rate for Payer: Vantage Medical Group Senior |
$31,170.74
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$5,856.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906820045
|
|
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 |
$2,635.20
|
| 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
|
|
