|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$41,319.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906820248
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,263.80 |
| Max. Negotiated Rate |
$37,187.10 |
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Central Health Plan Commercial |
$33,055.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,527.60
|
| Rate for Payer: Galaxy Health WC |
$35,121.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24,791.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$37,187.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,559.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,742.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,263.80
|
| Rate for Payer: Multiplan Commercial |
$30,989.25
|
| Rate for Payer: Networks By Design Commercial |
$26,857.35
|
| Rate for Payer: Prime Health Services Commercial |
$35,121.15
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
OP
|
$41,319.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,252.97 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,674.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$24,791.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$29,674.56
|
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Central Health Plan Commercial |
$33,055.20
|
| Rate for Payer: Cigna of CA PPO |
$30,576.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$35,121.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24,791.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$37,187.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30,989.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,666.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,963.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,674.56
|
| Rate for Payer: InnovAge PACE Commercial |
$44,511.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,559.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,263.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,763.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$30,989.25
|
| Rate for Payer: Networks By Design Commercial |
$26,857.35
|
| Rate for Payer: Prime Health Services Commercial |
$35,121.15
|
| Rate for Payer: Prime Health Services Medicare |
$31,455.03
|
| Rate for Payer: Riverside University Health System MISP |
$32,642.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,791.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24,791.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$41,319.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,263.80 |
| Max. Negotiated Rate |
$37,187.10 |
| Rate for Payer: Cash Price |
$18,593.55
|
| Rate for Payer: Central Health Plan Commercial |
$33,055.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,527.60
|
| Rate for Payer: Galaxy Health WC |
$35,121.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24,791.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$37,187.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,559.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,742.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,263.80
|
| Rate for Payer: Multiplan Commercial |
$30,989.25
|
| Rate for Payer: Networks By Design Commercial |
$26,857.35
|
| Rate for Payer: Prime Health Services Commercial |
$35,121.15
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906820249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,694.00 |
| Max. Negotiated Rate |
$34,623.00 |
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Central Health Plan Commercial |
$30,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,388.00
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,657.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,694.00
|
| Rate for Payer: Multiplan Commercial |
$28,852.50
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,672.42 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,674.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,082.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$29,674.56
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Central Health Plan Commercial |
$30,776.00
|
| Rate for Payer: Cigna of CA PPO |
$28,467.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,623.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,852.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,666.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,963.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,674.56
|
| Rate for Payer: InnovAge PACE Commercial |
$44,511.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,763.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$28,852.50
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
| Rate for Payer: Prime Health Services Medicare |
$31,455.03
|
| Rate for Payer: Riverside University Health System MISP |
$32,642.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,082.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906820249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,672.42 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,674.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,674.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,082.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$29,674.56
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Central Health Plan Commercial |
$30,776.00
|
| Rate for Payer: Cigna of CA PPO |
$28,467.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Dignity Health Media |
$29,674.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,642.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,060.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,674.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,674.56
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,623.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,852.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,666.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,963.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,674.56
|
| Rate for Payer: InnovAge PACE Commercial |
$44,511.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,672.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,674.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,763.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,763.91
|
| Rate for Payer: Multiplan Commercial |
$28,852.50
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
| Rate for Payer: Prime Health Services Medicare |
$31,455.03
|
| Rate for Payer: Riverside University Health System MISP |
$32,642.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,082.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,511.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,642.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,674.56
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$38,470.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,694.00 |
| Max. Negotiated Rate |
$34,623.00 |
| Rate for Payer: Cash Price |
$17,311.50
|
| Rate for Payer: Central Health Plan Commercial |
$30,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,388.00
|
| Rate for Payer: Galaxy Health WC |
$32,699.50
|
| Rate for Payer: Global Benefits Group Commercial |
$23,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,657.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,694.00
|
| Rate for Payer: Multiplan Commercial |
$28,852.50
|
| Rate for Payer: Networks By Design Commercial |
$25,005.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,699.50
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,232.80 |
| Max. Negotiated Rate |
$5,547.60 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906820045
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,232.80 |
| Max. Negotiated Rate |
$5,547.60 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906820045
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$80.68 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,453.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: InnovAge PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Riverside University Health System MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$80.68 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,453.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: InnovAge PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Riverside University Health System MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$133.39 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,453.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: InnovAge PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Riverside University Health System MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,232.80 |
| Max. Negotiated Rate |
$5,547.60 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$133.39 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,486.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,486.99
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: Cigna of CA HMO |
$3,944.96
|
| Rate for Payer: Cigna of CA PPO |
$4,561.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Media |
$1,486.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,486.99
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,438.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,453.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: InnovAge PACE Commercial |
$2,230.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,486.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,992.57
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,576.21
|
| Rate for Payer: Riverside University Health System MISP |
$1,635.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,232.80 |
| Max. Negotiated Rate |
$5,547.60 |
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,465.60
|
| Rate for Payer: Galaxy Health WC |
$5,239.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,547.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,348.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.80
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: Networks By Design Commercial |
$4,006.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,239.40
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$471.53 |
| Max. Negotiated Rate |
$15,396.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,331.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$471.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,361.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$9,331.00
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,481.60
|
| Rate for Payer: Cigna of CA HMO |
$6,785.28
|
| Rate for Payer: Cigna of CA PPO |
$7,845.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,541.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,951.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,302.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,396.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,331.00
|
| Rate for Payer: InnovAge PACE Commercial |
$13,996.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,120.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,503.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$7,951.50
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
| Rate for Payer: Prime Health Services Medicare |
$9,890.86
|
| Rate for Payer: Riverside University Health System MISP |
$10,264.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,361.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,361.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$471.53 |
| Max. Negotiated Rate |
$15,396.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,331.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$471.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,361.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$9,331.00
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,481.60
|
| Rate for Payer: Cigna of CA HMO |
$6,785.28
|
| Rate for Payer: Cigna of CA PPO |
$7,845.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,541.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,951.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,302.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,396.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,331.00
|
| Rate for Payer: InnovAge PACE Commercial |
$13,996.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,120.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,503.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$7,951.50
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
| Rate for Payer: Prime Health Services Medicare |
$9,890.86
|
| Rate for Payer: Riverside University Health System MISP |
$10,264.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,361.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,361.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,120.40 |
| Max. Negotiated Rate |
$9,541.80 |
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,481.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,240.80
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,541.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,039.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,120.40
|
| Rate for Payer: Multiplan Commercial |
$7,951.50
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$10,602.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,120.40 |
| Max. Negotiated Rate |
$9,541.80 |
| Rate for Payer: Cash Price |
$4,770.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,481.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,240.80
|
| Rate for Payer: Galaxy Health WC |
$9,011.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,361.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,541.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,071.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,039.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,120.40
|
| Rate for Payer: Multiplan Commercial |
$7,951.50
|
| Rate for Payer: Networks By Design Commercial |
$6,891.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,011.70
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
IP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906820048
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,767.20 |
| Max. Negotiated Rate |
$12,452.40 |
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,068.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,452.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,271.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,767.20
|
| Rate for Payer: Multiplan Commercial |
$10,377.00
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$12,452.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,609.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,609.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,301.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,068.80
|
| Rate for Payer: Cigna of CA HMO |
$8,855.04
|
| Rate for Payer: Cigna of CA PPO |
$10,238.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Dignity Health Media |
$11,760.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,760.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,452.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,377.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,842.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,767.20
|
| Rate for Payer: Multiplan Commercial |
$10,377.00
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
| Rate for Payer: Riverside University Health System MISP |
$5,534.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,301.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,301.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,760.60
|
| Rate for Payer: Vantage Medical Group Senior |
$11,760.60
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906820048
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$12,452.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,609.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,609.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,301.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,068.80
|
| Rate for Payer: Cigna of CA HMO |
$8,855.04
|
| Rate for Payer: Cigna of CA PPO |
$10,238.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,760.60
|
| Rate for Payer: Dignity Health Media |
$11,760.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,760.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,452.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,377.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,842.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,767.20
|
| Rate for Payer: Multiplan Commercial |
$10,377.00
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
| Rate for Payer: Riverside University Health System MISP |
$5,534.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,301.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,301.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,760.60
|
| Rate for Payer: Vantage Medical Group Senior |
$11,760.60
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
IP
|
$13,836.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,767.20 |
| Max. Negotiated Rate |
$12,452.40 |
| Rate for Payer: Cash Price |
$6,226.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,068.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,534.40
|
| Rate for Payer: Galaxy Health WC |
$11,760.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,301.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,452.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,271.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,767.20
|
| Rate for Payer: Multiplan Commercial |
$10,377.00
|
| Rate for Payer: Networks By Design Commercial |
$8,993.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,760.60
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
OP
|
$8,975.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906820049
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,936.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,936.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,385.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,180.00
|
| Rate for Payer: Cigna of CA HMO |
$5,744.00
|
| Rate for Payer: Cigna of CA PPO |
$6,641.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Dignity Health Media |
$7,628.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,628.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,590.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,590.00
|
| Rate for Payer: Galaxy Health WC |
$7,628.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,385.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,077.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,731.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,141.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,986.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,795.00
|
| Rate for Payer: Multiplan Commercial |
$6,731.25
|
| Rate for Payer: Networks By Design Commercial |
$5,833.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,628.75
|
| Rate for Payer: Riverside University Health System MISP |
$3,590.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,385.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,385.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,628.75
|
| Rate for Payer: Vantage Medical Group Senior |
$7,628.75
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
OP
|
$8,975.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,936.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,936.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,385.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Cash Price |
$4,038.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,180.00
|
| Rate for Payer: Cigna of CA HMO |
$5,744.00
|
| Rate for Payer: Cigna of CA PPO |
$6,641.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,628.75
|
| Rate for Payer: Dignity Health Media |
$7,628.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,628.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,590.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,590.00
|
| Rate for Payer: Galaxy Health WC |
$7,628.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,385.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,077.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,731.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,141.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,986.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,328.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,795.00
|
| Rate for Payer: Multiplan Commercial |
$6,731.25
|
| Rate for Payer: Networks By Design Commercial |
$5,833.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,628.75
|
| Rate for Payer: Riverside University Health System MISP |
$3,590.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,385.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,385.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,628.75
|
| Rate for Payer: Vantage Medical Group Senior |
$7,628.75
|
|
