|
HC EP STIMULATION BY MEDICATION
|
Facility
|
OP
|
$840.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906811482
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$168.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$198.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$510.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$406.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$493.33
|
| 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 |
$462.00
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Central Health Plan Commercial |
$672.00
|
| Rate for Payer: Cigna of CA HMO |
$537.60
|
| Rate for Payer: Cigna of CA PPO |
$621.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$714.00
|
| Rate for Payer: Global Benefits Group Commercial |
$504.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$756.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: InnovAge PACE Commercial |
$298.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$560.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$630.00
|
| Rate for Payer: Networks By Design Commercial |
$546.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$198.80
|
| Rate for Payer: Prime Health Services Commercial |
$714.00
|
| Rate for Payer: Prime Health Services Medicare |
$210.73
|
| Rate for Payer: Riverside University Health System MISP |
$218.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$504.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$504.00
|
| 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 |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC EP ST J ABLATION CABLE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC EP ST J ABLATION CABLE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC EP ST J ENSITE PRECISION PATCH
|
Facility
|
IP
|
$3,510.00
|
|
| Hospital Charge Code |
906812730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$3,159.00 |
| Rate for Payer: Adventist Health Commercial |
$702.00
|
| Rate for Payer: Cash Price |
$1,930.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,808.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,404.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,404.00
|
| Rate for Payer: Galaxy Health WC |
$2,983.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,106.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,159.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,341.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,337.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,172.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.00
|
| Rate for Payer: Multiplan Commercial |
$2,632.50
|
| Rate for Payer: Networks By Design Commercial |
$2,281.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,983.50
|
|
|
HC EP ST J ENSITE PRECISION PATCH
|
Facility
|
OP
|
$3,510.00
|
|
| Hospital Charge Code |
906812730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$3,159.00 |
| Rate for Payer: Adventist Health Commercial |
$702.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,131.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,983.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,930.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,632.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,699.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,061.42
|
| Rate for Payer: Blue Shield of California Commercial |
$2,144.61
|
| Rate for Payer: Blue Shield of California EPN |
$1,400.49
|
| Rate for Payer: Cash Price |
$1,930.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,808.00
|
| Rate for Payer: Cigna of CA HMO |
$2,246.40
|
| Rate for Payer: Cigna of CA PPO |
$2,597.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,983.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,983.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,983.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,404.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,404.00
|
| Rate for Payer: Galaxy Health WC |
$2,983.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,106.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,159.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,755.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,341.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,337.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,172.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,457.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,457.00
|
| Rate for Payer: Multiplan Commercial |
$2,632.50
|
| Rate for Payer: Networks By Design Commercial |
$2,281.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,983.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,404.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,106.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,106.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,755.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,755.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,755.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,755.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,983.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,983.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,983.50
|
|
|
HC EP ST J LIVEWIRE DECA PURPOSE
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC EP ST J LIVEWIRE DECA PURPOSE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC EP ST J LIVEWIRE DECA SUPER LG
|
Facility
|
OP
|
$3,853.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812641
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.60 |
| Max. Negotiated Rate |
$3,467.70 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,339.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,275.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,119.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,889.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,865.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,262.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,354.18
|
| Rate for Payer: Blue Shield of California EPN |
$1,537.35
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: Cigna of CA HMO |
$2,465.92
|
| Rate for Payer: Cigna of CA PPO |
$2,851.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,275.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,275.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,275.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,541.20
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,926.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,569.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,467.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,385.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,697.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,697.10
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,541.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,311.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,311.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,926.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,926.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,926.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,926.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,275.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,275.05
|
| Rate for Payer: Vantage Medical Group Senior |
$3,275.05
|
|
|
HC EP ST J LIVEWIRE DECA SUPER LG
|
Facility
|
IP
|
$3,853.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812641
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.60 |
| Max. Negotiated Rate |
$3,467.70 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,541.20
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,569.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,467.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,385.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
IP
|
$7,334.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906820042
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,466.80 |
| Max. Negotiated Rate |
$6,600.60 |
| Rate for Payer: Adventist Health Commercial |
$1,466.80
|
| Rate for Payer: Cash Price |
$4,033.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,867.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,933.60
|
| Rate for Payer: Galaxy Health WC |
$6,233.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,600.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,891.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,794.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,539.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,466.80
|
| Rate for Payer: Multiplan Commercial |
$5,500.50
|
| Rate for Payer: Networks By Design Commercial |
$4,767.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,233.90
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
OP
|
$6,234.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$505.61 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,246.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,298.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,428.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,675.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,018.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,661.23
|
| 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 |
$3,428.70
|
| Rate for Payer: Cash Price |
$3,428.70
|
| Rate for Payer: Cash Price |
$3,428.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,987.20
|
| Rate for Payer: Cigna of CA HMO |
$3,989.76
|
| Rate for Payer: Cigna of CA PPO |
$4,613.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,298.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,298.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,298.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,493.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,493.60
|
| Rate for Payer: Galaxy Health WC |
$5,298.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,740.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.61
|
| Rate for Payer: InnovAge PACE Commercial |
$3,117.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,858.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,246.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,363.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,363.80
|
| Rate for Payer: Multiplan Commercial |
$4,675.50
|
| Rate for Payer: Networks By Design Commercial |
$4,052.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,298.90
|
| Rate for Payer: Riverside University Health System MISP |
$2,493.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,740.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,740.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,298.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,298.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,298.90
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
OP
|
$7,334.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906820042
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$505.61 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,466.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,233.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,033.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,500.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,551.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,307.26
|
| 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 |
$4,033.70
|
| Rate for Payer: Cash Price |
$4,033.70
|
| Rate for Payer: Cash Price |
$4,033.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,867.20
|
| Rate for Payer: Cigna of CA HMO |
$4,693.76
|
| Rate for Payer: Cigna of CA PPO |
$5,427.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,233.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,233.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,233.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,933.60
|
| Rate for Payer: Galaxy Health WC |
$6,233.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,600.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.61
|
| Rate for Payer: InnovAge PACE Commercial |
$3,667.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,891.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,539.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,466.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,133.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,133.80
|
| Rate for Payer: Multiplan Commercial |
$5,500.50
|
| Rate for Payer: Networks By Design Commercial |
$4,767.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,233.90
|
| Rate for Payer: Riverside University Health System MISP |
$2,933.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,400.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,400.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,233.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,233.90
|
| Rate for Payer: Vantage Medical Group Senior |
$6,233.90
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
IP
|
$6,234.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,246.80 |
| Max. Negotiated Rate |
$5,610.60 |
| Rate for Payer: Adventist Health Commercial |
$1,246.80
|
| Rate for Payer: Cash Price |
$3,428.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,987.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,493.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,493.60
|
| Rate for Payer: Galaxy Health WC |
$5,298.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,740.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,610.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,375.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,858.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,246.80
|
| Rate for Payer: Multiplan Commercial |
$4,675.50
|
| Rate for Payer: Networks By Design Commercial |
$4,052.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,298.90
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
OP
|
$5,985.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$182.11 |
| Max. Negotiated Rate |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$1,197.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,634.69
|
| 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 |
$2,897.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,514.99
|
| 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 |
$3,291.75
|
| Rate for Payer: Cash Price |
$3,291.75
|
| Rate for Payer: Cash Price |
$3,291.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,788.00
|
| Rate for Payer: Cigna of CA HMO |
$3,830.40
|
| Rate for Payer: Cigna of CA PPO |
$4,428.90
|
| 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 |
$5,087.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,591.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,386.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.11
|
| 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 |
$3,991.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,197.00
|
| 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 |
$4,488.75
|
| Rate for Payer: Networks By Design Commercial |
$3,890.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$5,087.25
|
| 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 |
$3,591.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,591.00
|
| 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 VENTRICULAR PACING
|
Facility
|
IP
|
$7,041.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906820044
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,408.20 |
| Max. Negotiated Rate |
$6,336.90 |
| Rate for Payer: Adventist Health Commercial |
$1,408.20
|
| Rate for Payer: Cash Price |
$3,872.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,816.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,816.40
|
| Rate for Payer: Galaxy Health WC |
$5,984.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,224.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,336.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,696.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,682.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,358.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,408.20
|
| Rate for Payer: Multiplan Commercial |
$5,280.75
|
| Rate for Payer: Networks By Design Commercial |
$4,576.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,984.85
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
IP
|
$5,985.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,197.00 |
| Max. Negotiated Rate |
$5,386.50 |
| Rate for Payer: Adventist Health Commercial |
$1,197.00
|
| Rate for Payer: Cash Price |
$3,291.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,788.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,394.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,394.00
|
| Rate for Payer: Galaxy Health WC |
$5,087.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,591.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,991.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,280.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,704.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,197.00
|
| Rate for Payer: Multiplan Commercial |
$4,488.75
|
| Rate for Payer: Networks By Design Commercial |
$3,890.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,087.25
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
OP
|
$7,041.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906820044
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$182.11 |
| Max. Negotiated Rate |
$15,811.96 |
| Rate for Payer: Adventist Health Commercial |
$1,408.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,641.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,276.00
|
| 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 |
$3,409.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,135.18
|
| 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 |
$3,872.55
|
| Rate for Payer: Cash Price |
$3,872.55
|
| Rate for Payer: Cash Price |
$3,872.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,632.80
|
| Rate for Payer: Cigna of CA HMO |
$4,506.24
|
| Rate for Payer: Cigna of CA PPO |
$5,210.34
|
| 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 |
$5,984.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,224.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,336.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,811.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.11
|
| 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 |
$4,696.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,641.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,408.20
|
| 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 |
$5,280.75
|
| Rate for Payer: Networks By Design Commercial |
$4,576.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Prime Health Services Commercial |
$5,984.85
|
| 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 |
$4,224.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,224.60
|
| 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 ERCP BILIARY/SPHINCT
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.32 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Adventist Health Commercial |
$385.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,169.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,058.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,443.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,168.47
|
| Rate for Payer: Blue Shield of California EPN |
$764.23
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: Cigna of CA HMO |
$1,232.00
|
| Rate for Payer: Cigna of CA PPO |
$1,424.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,636.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,636.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: EPIC Health Plan Senior |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.02
|
| Rate for Payer: InnovAge PACE Commercial |
$962.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,347.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,347.50
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
| Rate for Payer: Riverside University Health System MISP |
$770.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,155.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,155.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$962.50
|
| Rate for Payer: United Healthcare All Other HMO |
$962.50
|
| Rate for Payer: United Healthcare HMO Rider |
$962.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$962.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,636.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,636.25
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$198.02 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$385.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,058.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,443.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,130.55
|
| 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 |
$1,058.75
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: Cigna of CA HMO |
$1,232.00
|
| Rate for Payer: Cigna of CA PPO |
$1,424.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,636.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,636.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: EPIC Health Plan Senior |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.02
|
| Rate for Payer: InnovAge PACE Commercial |
$962.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,347.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,347.50
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
| Rate for Payer: Riverside University Health System MISP |
$770.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,155.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,155.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$962.50
|
| Rate for Payer: United Healthcare All Other HMO |
$962.50
|
| Rate for Payer: United Healthcare HMO Rider |
$962.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$962.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,636.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,636.25
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$385.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Adventist Health Commercial |
$385.00
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: EPIC Health Plan Senior |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$733.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$385.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Adventist Health Commercial |
$385.00
|
| Rate for Payer: Cash Price |
$1,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: EPIC Health Plan Senior |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$733.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
OP
|
$2,291.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.32 |
| Max. Negotiated Rate |
$2,061.90 |
| Rate for Payer: Adventist Health Commercial |
$458.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,391.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,947.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,260.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,718.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,390.64
|
| Rate for Payer: Blue Shield of California EPN |
$909.53
|
| Rate for Payer: Cash Price |
$1,260.05
|
| Rate for Payer: Cash Price |
$1,260.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.80
|
| Rate for Payer: Cigna of CA HMO |
$1,466.24
|
| Rate for Payer: Cigna of CA PPO |
$1,695.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,947.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,947.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,947.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.40
|
| Rate for Payer: EPIC Health Plan Senior |
$916.40
|
| Rate for Payer: Galaxy Health WC |
$1,947.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.02
|
| Rate for Payer: InnovAge PACE Commercial |
$1,145.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,528.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,418.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,603.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,603.70
|
| Rate for Payer: Multiplan Commercial |
$1,718.25
|
| Rate for Payer: Networks By Design Commercial |
$1,489.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,947.35
|
| Rate for Payer: Riverside University Health System MISP |
$916.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,374.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,374.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,145.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,145.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,145.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,145.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,947.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,947.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,947.35
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
IP
|
$2,291.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$458.20 |
| Max. Negotiated Rate |
$2,061.90 |
| Rate for Payer: Adventist Health Commercial |
$458.20
|
| Rate for Payer: Cash Price |
$1,260.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.40
|
| Rate for Payer: EPIC Health Plan Senior |
$916.40
|
| Rate for Payer: Galaxy Health WC |
$1,947.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,528.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$872.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,418.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.20
|
| Rate for Payer: Multiplan Commercial |
$1,718.25
|
| Rate for Payer: Networks By Design Commercial |
$1,489.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,947.35
|
|
