|
HC IAP MONITORIN DEVICE
|
Facility
|
OP
|
$456.58
|
|
| Hospital Charge Code |
901698334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.32 |
| Max. Negotiated Rate |
$410.92 |
| Rate for Payer: Adventist Health Commercial |
$91.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$388.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$342.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$221.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$268.15
|
| Rate for Payer: Blue Shield of California Commercial |
$278.97
|
| Rate for Payer: Blue Shield of California EPN |
$182.18
|
| Rate for Payer: Cash Price |
$205.46
|
| Rate for Payer: Central Health Plan Commercial |
$365.26
|
| Rate for Payer: Cigna of CA HMO |
$292.21
|
| Rate for Payer: Cigna of CA PPO |
$337.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$388.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$388.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$388.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.63
|
| Rate for Payer: EPIC Health Plan Senior |
$182.63
|
| Rate for Payer: Galaxy Health WC |
$388.09
|
| Rate for Payer: Global Benefits Group Commercial |
$273.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$410.92
|
| Rate for Payer: InnovAge PACE Commercial |
$228.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$319.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$319.61
|
| Rate for Payer: Multiplan Commercial |
$342.44
|
| Rate for Payer: Networks By Design Commercial |
$296.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.09
|
| Rate for Payer: Riverside University Health System MISP |
$182.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$273.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$273.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.29
|
| Rate for Payer: United Healthcare All Other HMO |
$228.29
|
| Rate for Payer: United Healthcare HMO Rider |
$228.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$388.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$388.09
|
| Rate for Payer: Vantage Medical Group Senior |
$388.09
|
|
|
HC IAP MONITORIN DEVICE
|
Facility
|
IP
|
$456.58
|
|
| Hospital Charge Code |
901698334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.32 |
| Max. Negotiated Rate |
$410.92 |
| Rate for Payer: Adventist Health Commercial |
$91.32
|
| Rate for Payer: Cash Price |
$205.46
|
| Rate for Payer: Central Health Plan Commercial |
$365.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.63
|
| Rate for Payer: EPIC Health Plan Senior |
$182.63
|
| Rate for Payer: Galaxy Health WC |
$388.09
|
| Rate for Payer: Global Benefits Group Commercial |
$273.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$410.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.32
|
| Rate for Payer: Multiplan Commercial |
$342.44
|
| Rate for Payer: Networks By Design Commercial |
$296.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.09
|
|
|
HC IAP MONITORING DEVICE
|
Facility
|
IP
|
$544.62
|
|
| Hospital Charge Code |
901698404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.92 |
| Max. Negotiated Rate |
$490.16 |
| Rate for Payer: Adventist Health Commercial |
$108.92
|
| Rate for Payer: Cash Price |
$245.08
|
| Rate for Payer: Central Health Plan Commercial |
$435.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$217.85
|
| Rate for Payer: EPIC Health Plan Senior |
$217.85
|
| Rate for Payer: Galaxy Health WC |
$462.93
|
| Rate for Payer: Global Benefits Group Commercial |
$326.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$490.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$363.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.92
|
| Rate for Payer: Multiplan Commercial |
$408.46
|
| Rate for Payer: Networks By Design Commercial |
$354.00
|
| Rate for Payer: Prime Health Services Commercial |
$462.93
|
|
|
HC IAP MONITORING DEVICE
|
Facility
|
OP
|
$544.62
|
|
| Hospital Charge Code |
901698404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.92 |
| Max. Negotiated Rate |
$490.16 |
| Rate for Payer: Adventist Health Commercial |
$108.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$330.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$462.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$299.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$263.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$319.86
|
| Rate for Payer: Blue Shield of California Commercial |
$332.76
|
| Rate for Payer: Blue Shield of California EPN |
$217.30
|
| Rate for Payer: Cash Price |
$245.08
|
| Rate for Payer: Central Health Plan Commercial |
$435.70
|
| Rate for Payer: Cigna of CA HMO |
$348.56
|
| Rate for Payer: Cigna of CA PPO |
$403.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$462.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$462.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$462.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$217.85
|
| Rate for Payer: EPIC Health Plan Senior |
$217.85
|
| Rate for Payer: Galaxy Health WC |
$462.93
|
| Rate for Payer: Global Benefits Group Commercial |
$326.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$490.16
|
| Rate for Payer: InnovAge PACE Commercial |
$272.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$363.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$381.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$381.23
|
| Rate for Payer: Multiplan Commercial |
$408.46
|
| Rate for Payer: Networks By Design Commercial |
$354.00
|
| Rate for Payer: Prime Health Services Commercial |
$462.93
|
| Rate for Payer: Riverside University Health System MISP |
$217.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$326.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$326.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.31
|
| Rate for Payer: United Healthcare All Other HMO |
$272.31
|
| Rate for Payer: United Healthcare HMO Rider |
$272.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$462.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$462.93
|
| Rate for Payer: Vantage Medical Group Senior |
$462.93
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
IP
|
$8,715.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906820051
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,743.00 |
| Max. Negotiated Rate |
$7,843.50 |
| Rate for Payer: Adventist Health Commercial |
$1,743.00
|
| Rate for Payer: Cash Price |
$3,921.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,486.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,486.00
|
| Rate for Payer: Galaxy Health WC |
$7,407.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,229.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,843.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,320.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,394.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,743.00
|
| Rate for Payer: Multiplan Commercial |
$6,536.25
|
| Rate for Payer: Networks By Design Commercial |
$5,664.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,407.75
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
OP
|
$10,022.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$2,004.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,518.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,512.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,516.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,852.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,885.92
|
| 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 |
$4,509.90
|
| Rate for Payer: Cash Price |
$4,509.90
|
| Rate for Payer: Cash Price |
$4,509.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,017.60
|
| Rate for Payer: Cigna of CA HMO |
$6,414.08
|
| Rate for Payer: Cigna of CA PPO |
$7,416.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,518.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,518.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,518.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,008.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,008.80
|
| Rate for Payer: Galaxy Health WC |
$8,518.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,013.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,019.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$934.06
|
| Rate for Payer: InnovAge PACE Commercial |
$5,011.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,684.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,031.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,203.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,004.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,015.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,015.40
|
| Rate for Payer: Multiplan Commercial |
$7,516.50
|
| Rate for Payer: Networks By Design Commercial |
$6,514.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,518.70
|
| Rate for Payer: Riverside University Health System MISP |
$4,008.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,013.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,013.20
|
| 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: Vantage Medical Group Commercial/Exchange |
$8,518.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,518.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,518.70
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,004.40 |
| Max. Negotiated Rate |
$9,019.80 |
| Rate for Payer: Adventist Health Commercial |
$2,004.40
|
| Rate for Payer: Cash Price |
$4,509.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,017.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,008.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,008.80
|
| Rate for Payer: Galaxy Health WC |
$8,518.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,013.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,019.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,684.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,818.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,203.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,004.40
|
| Rate for Payer: Multiplan Commercial |
$7,516.50
|
| Rate for Payer: Networks By Design Commercial |
$6,514.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,518.70
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
OP
|
$8,715.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906820051
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,743.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,793.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,536.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,219.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,118.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,921.75
|
| Rate for Payer: Cash Price |
$3,921.75
|
| Rate for Payer: Cash Price |
$3,921.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,972.00
|
| Rate for Payer: Cigna of CA HMO |
$5,577.60
|
| Rate for Payer: Cigna of CA PPO |
$6,449.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,407.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,407.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,486.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,486.00
|
| Rate for Payer: Galaxy Health WC |
$7,407.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,229.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,843.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$934.06
|
| Rate for Payer: InnovAge PACE Commercial |
$4,357.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,031.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,394.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,743.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,100.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,100.50
|
| Rate for Payer: Multiplan Commercial |
$6,536.25
|
| Rate for Payer: Networks By Design Commercial |
$5,664.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,407.75
|
| Rate for Payer: Riverside University Health System MISP |
$3,486.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,229.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,229.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,407.75
|
| Rate for Payer: Vantage Medical Group Senior |
$7,407.75
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
OP
|
$5,063.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.60 |
| Max. Negotiated Rate |
$44,438.00 |
| Rate for Payer: Adventist Health Commercial |
$1,012.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,303.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,784.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,797.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,278.35
|
| Rate for Payer: Cash Price |
$2,278.35
|
| Rate for Payer: Cash Price |
$2,278.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,050.40
|
| Rate for Payer: Cigna of CA HMO |
$3,240.32
|
| Rate for Payer: Cigna of CA PPO |
$3,746.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,303.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,303.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,303.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,025.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,025.20
|
| Rate for Payer: Galaxy Health WC |
$4,303.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,037.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,556.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,541.34
|
| Rate for Payer: InnovAge PACE Commercial |
$2,531.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,377.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,702.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,134.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,012.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,544.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,544.10
|
| Rate for Payer: Multiplan Commercial |
$3,797.25
|
| Rate for Payer: Networks By Design Commercial |
$3,290.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,303.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,025.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,037.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,303.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,303.55
|
| Rate for Payer: Vantage Medical Group Senior |
$4,303.55
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
IP
|
$5,956.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906820107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,191.20 |
| Max. Negotiated Rate |
$5,360.40 |
| Rate for Payer: Adventist Health Commercial |
$1,191.20
|
| Rate for Payer: Cash Price |
$2,680.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,764.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,382.40
|
| Rate for Payer: Galaxy Health WC |
$5,062.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,573.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,360.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,972.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,686.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.20
|
| Rate for Payer: Multiplan Commercial |
$4,467.00
|
| Rate for Payer: Networks By Design Commercial |
$3,871.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,062.60
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
IP
|
$5,063.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.60 |
| Max. Negotiated Rate |
$4,556.70 |
| Rate for Payer: Adventist Health Commercial |
$1,012.60
|
| Rate for Payer: Cash Price |
$2,278.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,050.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,025.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,025.20
|
| Rate for Payer: Galaxy Health WC |
$4,303.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,037.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,556.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,377.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,929.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,134.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,012.60
|
| Rate for Payer: Multiplan Commercial |
$3,797.25
|
| Rate for Payer: Networks By Design Commercial |
$3,290.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,303.55
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
OP
|
$5,956.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906820107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,191.20 |
| Max. Negotiated Rate |
$44,438.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,275.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,467.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,680.20
|
| Rate for Payer: Cash Price |
$2,680.20
|
| Rate for Payer: Cash Price |
$2,680.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,764.80
|
| Rate for Payer: Cigna of CA HMO |
$3,811.84
|
| Rate for Payer: Cigna of CA PPO |
$4,407.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,062.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,062.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,382.40
|
| Rate for Payer: Galaxy Health WC |
$5,062.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,573.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,360.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,541.34
|
| Rate for Payer: InnovAge PACE Commercial |
$2,978.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,972.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,702.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,686.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,169.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,169.20
|
| Rate for Payer: Multiplan Commercial |
$4,467.00
|
| Rate for Payer: Networks By Design Commercial |
$3,871.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,062.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,382.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,573.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,062.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,062.60
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$962.00 |
| Max. Negotiated Rate |
$4,329.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,924.00
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,208.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,832.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,977.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906820122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$258.07 |
| Max. Negotiated Rate |
$44,438.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,527.20
|
| Rate for Payer: Cigna of CA HMO |
$3,621.76
|
| Rate for Payer: Cigna of CA PPO |
$4,187.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,093.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$258.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$285.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,131.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906820122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,131.80 |
| Max. Negotiated Rate |
$5,093.10 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$2,546.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,263.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,263.60
|
| Rate for Payer: Galaxy Health WC |
$4,810.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,093.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,774.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,131.80
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Networks By Design Commercial |
$3,678.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,810.15
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$258.07 |
| Max. Negotiated Rate |
$44,438.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Cigna of CA HMO |
$3,078.40
|
| Rate for Payer: Cigna of CA PPO |
$3,559.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$258.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,208.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$285.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,886.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC ICD INSERT EXIST DUAL LEADS
|
Facility
|
OP
|
$76,817.00
|
|
|
Service Code
|
CPT 33230
|
| Hospital Charge Code |
906811425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$537.90 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$15,363.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$28,520.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,441.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Central Health Plan Commercial |
$61,453.60
|
| Rate for Payer: Cigna of CA HMO |
$49,162.88
|
| Rate for Payer: Cigna of CA PPO |
$56,844.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$65,294.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69,135.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$537.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: InnovAge PACE Commercial |
$42,780.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51,236.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$594.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,363.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,216.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$57,612.75
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$49,931.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Preferred Health Network WC |
$46,369.12
|
| Rate for Payer: Prime Health Services Commercial |
$65,294.45
|
| Rate for Payer: Prime Health Services Medicare |
$30,231.34
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Riverside University Health System MISP |
$31,372.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,090.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD INSERT EXIST DUAL LEADS
|
Facility
|
IP
|
$76,817.00
|
|
|
Service Code
|
CPT 33230
|
| Hospital Charge Code |
906811425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,363.40 |
| Max. Negotiated Rate |
$69,135.30 |
| Rate for Payer: Adventist Health Commercial |
$15,363.40
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Central Health Plan Commercial |
$61,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,726.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30,726.80
|
| Rate for Payer: Galaxy Health WC |
$65,294.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69,135.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51,236.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,267.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,549.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,363.40
|
| Rate for Payer: Multiplan Commercial |
$57,612.75
|
| Rate for Payer: Networks By Design Commercial |
$49,931.05
|
| Rate for Payer: Prime Health Services Commercial |
$65,294.45
|
|
|
HC ICD INSERT EXIST DUAL LEADS
|
Facility
|
OP
|
$90,373.00
|
|
|
Service Code
|
CPT 33230
|
| Hospital Charge Code |
906820218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$537.90 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$28,520.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,441.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Central Health Plan Commercial |
$72,298.40
|
| Rate for Payer: Cigna of CA HMO |
$57,838.72
|
| Rate for Payer: Cigna of CA PPO |
$66,876.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$81,335.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$537.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: InnovAge PACE Commercial |
$42,780.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$594.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,074.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,216.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$67,779.75
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Preferred Health Network WC |
$46,369.12
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
| Rate for Payer: Prime Health Services Medicare |
$30,231.34
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Riverside University Health System MISP |
$31,372.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54,223.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD INSERT EXIST DUAL LEADS
|
Facility
|
IP
|
$90,373.00
|
|
|
Service Code
|
CPT 33230
|
| Hospital Charge Code |
906820218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,074.60 |
| Max. Negotiated Rate |
$81,335.70 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Central Health Plan Commercial |
$72,298.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36,149.20
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$81,335.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,432.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,940.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,074.60
|
| Rate for Payer: Multiplan Commercial |
$67,779.75
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
|
|
HC ICD INSERT EXIST MULT HC LEADS
|
Facility
|
IP
|
$76,817.00
|
|
|
Service Code
|
CPT 33231
|
| Hospital Charge Code |
906811426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,363.40 |
| Max. Negotiated Rate |
$69,135.30 |
| Rate for Payer: Adventist Health Commercial |
$15,363.40
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Central Health Plan Commercial |
$61,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,726.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30,726.80
|
| Rate for Payer: Galaxy Health WC |
$65,294.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69,135.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51,236.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,267.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,549.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,363.40
|
| Rate for Payer: Multiplan Commercial |
$57,612.75
|
| Rate for Payer: Networks By Design Commercial |
$49,931.05
|
| Rate for Payer: Prime Health Services Commercial |
$65,294.45
|
|
|
HC ICD INSERT EXIST MULT HC LEADS
|
Facility
|
IP
|
$90,373.00
|
|
|
Service Code
|
CPT 33231
|
| Hospital Charge Code |
906820255
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,074.60 |
| Max. Negotiated Rate |
$81,335.70 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Central Health Plan Commercial |
$72,298.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36,149.20
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$81,335.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,432.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,940.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,074.60
|
| Rate for Payer: Multiplan Commercial |
$67,779.75
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
|
|
HC ICD INSERT EXIST MULT HC LEADS
|
Facility
|
OP
|
$90,373.00
|
|
|
Service Code
|
CPT 33231
|
| Hospital Charge Code |
906820255
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.40 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,074.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Cash Price |
$40,667.85
|
| Rate for Payer: Central Health Plan Commercial |
$72,298.40
|
| Rate for Payer: Cigna of CA HMO |
$57,838.72
|
| Rate for Payer: Cigna of CA PPO |
$66,876.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$76,817.05
|
| Rate for Payer: Global Benefits Group Commercial |
$54,223.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$81,335.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$558.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60,278.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$616.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,074.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$67,779.75
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$58,742.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$76,817.05
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54,223.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD INSERT EXIST MULT HC LEADS
|
Facility
|
OP
|
$76,817.00
|
|
|
Service Code
|
CPT 33231
|
| Hospital Charge Code |
906811426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.40 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$15,363.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Cash Price |
$34,567.65
|
| Rate for Payer: Central Health Plan Commercial |
$61,453.60
|
| Rate for Payer: Cigna of CA HMO |
$49,162.88
|
| Rate for Payer: Cigna of CA PPO |
$56,844.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$65,294.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69,135.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$558.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51,236.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$616.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,363.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$57,612.75
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$49,931.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$65,294.45
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,090.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD INSERT/REPL + DUAL LEADS
|
Facility
|
OP
|
$92,573.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906820211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,539.42 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,514.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$41,657.85
|
| Rate for Payer: Cash Price |
$41,657.85
|
| Rate for Payer: Cash Price |
$41,657.85
|
| Rate for Payer: Central Health Plan Commercial |
$74,058.40
|
| Rate for Payer: Cigna of CA HMO |
$59,246.72
|
| Rate for Payer: Cigna of CA PPO |
$68,504.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$78,687.05
|
| Rate for Payer: Global Benefits Group Commercial |
$55,543.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$83,315.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,539.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61,746.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,700.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,514.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$69,429.75
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$60,172.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$78,687.05
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55,543.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
