|
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 |
$26,032.05
|
| 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 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 |
$30,625.65
|
| Rate for Payer: Cash Price |
$30,625.65
|
| Rate for Payer: Cash Price |
$30,625.65
|
| 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
|
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 |
$26,032.05
|
| Rate for Payer: Cash Price |
$26,032.05
|
| Rate for Payer: Cash Price |
$26,032.05
|
| 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 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 |
$21,589.15
|
| Rate for Payer: Cash Price |
$21,589.15
|
| Rate for Payer: Cash Price |
$21,589.15
|
| 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
|
$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 |
$18,350.75
|
| 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
|
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 |
$21,589.15
|
| 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 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 |
$18,350.75
|
| Rate for Payer: Cash Price |
$18,350.75
|
| Rate for Payer: Cash Price |
$18,350.75
|
| 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 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 |
$20,100.30
|
| Rate for Payer: Cash Price |
$20,100.30
|
| Rate for Payer: Cash Price |
$20,100.30
|
| 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 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 |
$20,100.30
|
| 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
|
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 |
$17,085.20
|
| Rate for Payer: Cash Price |
$17,085.20
|
| Rate for Payer: Cash Price |
$17,085.20
|
| 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
|
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 |
$17,085.20
|
| 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 ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$141.04 |
| Max. Negotiated Rate |
$7,837.47 |
| 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 |
$3,023.14
|
| 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 |
$141.04
|
| 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 |
$155.80
|
| 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 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 |
$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 ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,737.90
|
| 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 ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$5,856.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906820045
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$141.04 |
| Max. Negotiated Rate |
$7,837.47 |
| 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 |
$3,556.35
|
| 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 |
$141.04
|
| 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 |
$155.80
|
| 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 ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,737.90
|
| 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 ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$160.79 |
| Max. Negotiated Rate |
$7,837.47 |
| 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 |
$3,023.14
|
| 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 |
$160.79
|
| 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 |
$177.61
|
| 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 ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$5,856.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$160.79 |
| Max. Negotiated Rate |
$7,837.47 |
| 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 |
$3,556.35
|
| 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 |
$160.79
|
| 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 |
$177.61
|
| 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 ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$5,856.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
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 FOLLOW-UP STUDY
|
Facility
|
IP
|
$12,192.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,438.40 |
| Max. Negotiated Rate |
$10,972.80 |
| Rate for Payer: Adventist Health Commercial |
$2,438.40
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,876.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,876.80
|
| Rate for Payer: Galaxy Health WC |
$10,363.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,972.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,132.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,645.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,546.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,438.40
|
| Rate for Payer: Multiplan Commercial |
$9,144.00
|
| Rate for Payer: Networks By Design Commercial |
$7,924.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,363.20
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$14,021.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$491.27 |
| Max. Negotiated Rate |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$2,804.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,514.95
|
| 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 |
$6,788.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,234.53
|
| 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 |
$7,711.55
|
| Rate for Payer: Cash Price |
$7,711.55
|
| Rate for Payer: Cash Price |
$7,711.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,216.80
|
| Rate for Payer: Cigna of CA HMO |
$8,973.44
|
| Rate for Payer: Cigna of CA PPO |
$10,375.54
|
| 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 |
$11,917.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,412.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,618.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$491.27
|
| 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 |
$9,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,804.20
|
| 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 |
$10,515.75
|
| Rate for Payer: Networks By Design Commercial |
$9,113.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$11,917.85
|
| 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 |
$8,412.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,412.60
|
| 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 FOLLOW-UP STUDY
|
Facility
|
IP
|
$14,021.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,804.20 |
| Max. Negotiated Rate |
$12,618.90 |
| Rate for Payer: Adventist Health Commercial |
$2,804.20
|
| Rate for Payer: Cash Price |
$7,711.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,216.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,608.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,608.40
|
| Rate for Payer: Galaxy Health WC |
$11,917.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,412.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,618.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,342.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,679.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,804.20
|
| Rate for Payer: Multiplan Commercial |
$10,515.75
|
| Rate for Payer: Networks By Design Commercial |
$9,113.65
|
| Rate for Payer: Prime Health Services Commercial |
$11,917.85
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$12,192.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$491.27 |
| Max. Negotiated Rate |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$2,438.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,404.20
|
| 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 |
$5,903.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,160.36
|
| 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 |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,753.60
|
| Rate for Payer: Cigna of CA HMO |
$7,802.88
|
| Rate for Payer: Cigna of CA PPO |
$9,022.08
|
| 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 |
$10,363.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,972.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$491.27
|
| 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 |
$8,132.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,438.40
|
| 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 |
$9,144.00
|
| Rate for Payer: Networks By Design Commercial |
$7,924.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$10,363.20
|
| 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 |
$7,315.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,315.20
|
| 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 LA/CS PACING & RECORDING
|
Facility
|
OP
|
$15,911.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906820048
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$14,319.90 |
| Rate for Payer: Adventist Health Commercial |
$3,182.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,524.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,751.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,933.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,704.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,344.53
|
| 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 |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,728.80
|
| Rate for Payer: Cigna of CA HMO |
$10,183.04
|
| Rate for Payer: Cigna of CA PPO |
$11,774.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,524.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,524.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,524.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,364.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,364.40
|
| Rate for Payer: Galaxy Health WC |
$13,524.35
|
| Rate for Payer: Global Benefits Group Commercial |
$9,546.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,319.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: InnovAge PACE Commercial |
$7,955.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,612.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,848.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,182.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,137.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,137.70
|
| Rate for Payer: Multiplan Commercial |
$11,933.25
|
| Rate for Payer: Networks By Design Commercial |
$10,342.15
|
| Rate for Payer: Prime Health Services Commercial |
$13,524.35
|
| Rate for Payer: Riverside University Health System MISP |
$6,364.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,546.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,546.60
|
| 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 |
$13,524.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,524.35
|
| Rate for Payer: Vantage Medical Group Senior |
$13,524.35
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$18,298.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$16,468.20 |
| Rate for Payer: Adventist Health Commercial |
$3,659.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,063.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,723.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,859.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,746.42
|
| 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 |
$10,063.90
|
| Rate for Payer: Cash Price |
$10,063.90
|
| Rate for Payer: Cash Price |
$10,063.90
|
| Rate for Payer: Central Health Plan Commercial |
$14,638.40
|
| Rate for Payer: Cigna of CA HMO |
$11,710.72
|
| Rate for Payer: Cigna of CA PPO |
$13,540.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,553.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,553.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,319.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,319.20
|
| Rate for Payer: Galaxy Health WC |
$15,553.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10,978.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,468.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: InnovAge PACE Commercial |
$9,149.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,204.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,326.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,659.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,808.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,808.60
|
| Rate for Payer: Multiplan Commercial |
$13,723.50
|
| Rate for Payer: Networks By Design Commercial |
$11,893.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,553.30
|
| Rate for Payer: Riverside University Health System MISP |
$7,319.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,978.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,978.80
|
| 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: Vantage Medical Group Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,553.30
|
| Rate for Payer: Vantage Medical Group Senior |
$15,553.30
|
|
