|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
IP
|
$97,445.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906820125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,489.00 |
| Max. Negotiated Rate |
$87,700.50 |
| Rate for Payer: Cash Price |
$43,850.25
|
| Rate for Payer: Central Health Plan Commercial |
$77,956.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,978.00
|
| Rate for Payer: Galaxy Health WC |
$82,828.25
|
| Rate for Payer: Global Benefits Group Commercial |
$58,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$87,700.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64,995.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37,126.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,489.00
|
| Rate for Payer: Multiplan Commercial |
$73,083.75
|
| Rate for Payer: Networks By Design Commercial |
$63,339.25
|
| Rate for Payer: Prime Health Services Commercial |
$82,828.25
|
|
|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
OP
|
$97,445.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906820125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,700.52 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$41,105.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,196.73
|
| Rate for Payer: Blue Distinction Transplant |
$58,467.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$41,105.24
|
| Rate for Payer: Cash Price |
$43,850.25
|
| Rate for Payer: Cash Price |
$43,850.25
|
| Rate for Payer: Cash Price |
$43,850.25
|
| Rate for Payer: Central Health Plan Commercial |
$77,956.00
|
| Rate for Payer: Cigna of CA PPO |
$72,109.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$82,828.25
|
| Rate for Payer: Global Benefits Group Commercial |
$58,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$87,700.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$73,083.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67,823.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: InnovAge PACE Commercial |
$61,657.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64,995.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,700.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,489.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,081.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$73,083.75
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$63,339.25
|
| Rate for Payer: Preferred Health Network WC |
$57,343.60
|
| Rate for Payer: Prime Health Services Commercial |
$82,828.25
|
| Rate for Payer: Prime Health Services Medicare |
$43,571.55
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Riverside University Health System MISP |
$45,215.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58,467.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
IP
|
$97,445.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,489.00 |
| Max. Negotiated Rate |
$87,700.50 |
| Rate for Payer: Cash Price |
$43,850.25
|
| Rate for Payer: Central Health Plan Commercial |
$77,956.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,978.00
|
| Rate for Payer: Galaxy Health WC |
$82,828.25
|
| Rate for Payer: Global Benefits Group Commercial |
$58,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$87,700.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64,995.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37,126.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,489.00
|
| Rate for Payer: Multiplan Commercial |
$73,083.75
|
| Rate for Payer: Networks By Design Commercial |
$63,339.25
|
| Rate for Payer: Prime Health Services Commercial |
$82,828.25
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
IP
|
$84,570.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906820124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,914.00 |
| Max. Negotiated Rate |
$76,113.00 |
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Central Health Plan Commercial |
$67,656.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,828.00
|
| Rate for Payer: Galaxy Health WC |
$71,884.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50,742.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76,113.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,408.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,221.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,914.00
|
| Rate for Payer: Multiplan Commercial |
$63,427.50
|
| Rate for Payer: Networks By Design Commercial |
$54,970.50
|
| Rate for Payer: Prime Health Services Commercial |
$71,884.50
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
OP
|
$84,570.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,450.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,450.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,263.62
|
| Rate for Payer: Blue Distinction Transplant |
$50,742.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$29,450.93
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Central Health Plan Commercial |
$67,656.00
|
| Rate for Payer: Cigna of CA PPO |
$62,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Dignity Health Media |
$29,450.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,396.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,758.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,450.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,450.93
|
| Rate for Payer: Galaxy Health WC |
$71,884.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50,742.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76,113.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$63,427.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,299.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,594.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,450.93
|
| Rate for Payer: InnovAge PACE Commercial |
$44,176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,408.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,450.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,914.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,464.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,464.25
|
| Rate for Payer: Multiplan Commercial |
$63,427.50
|
| Rate for Payer: Multiplan WC |
$40,263.62
|
| Rate for Payer: Networks By Design Commercial |
$54,970.50
|
| Rate for Payer: Preferred Health Network WC |
$41,085.33
|
| Rate for Payer: Prime Health Services Commercial |
$71,884.50
|
| Rate for Payer: Prime Health Services Medicare |
$31,217.99
|
| Rate for Payer: Prime Health Services WC |
$39,852.77
|
| Rate for Payer: Riverside University Health System MISP |
$32,396.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50,742.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,450.93
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
OP
|
$84,570.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906820124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,450.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,450.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,263.62
|
| Rate for Payer: Blue Distinction Transplant |
$50,742.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$29,450.93
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Central Health Plan Commercial |
$67,656.00
|
| Rate for Payer: Cigna of CA PPO |
$62,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Dignity Health Media |
$29,450.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,396.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,758.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,450.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,450.93
|
| Rate for Payer: Galaxy Health WC |
$71,884.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50,742.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76,113.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$63,427.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,299.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,594.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,450.93
|
| Rate for Payer: InnovAge PACE Commercial |
$44,176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,408.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,450.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,914.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,464.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,464.25
|
| Rate for Payer: Multiplan Commercial |
$63,427.50
|
| Rate for Payer: Multiplan WC |
$40,263.62
|
| Rate for Payer: Networks By Design Commercial |
$54,970.50
|
| Rate for Payer: Preferred Health Network WC |
$41,085.33
|
| Rate for Payer: Prime Health Services Commercial |
$71,884.50
|
| Rate for Payer: Prime Health Services Medicare |
$31,217.99
|
| Rate for Payer: Prime Health Services WC |
$39,852.77
|
| Rate for Payer: Riverside University Health System MISP |
$32,396.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50,742.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,450.93
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
IP
|
$84,570.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,914.00 |
| Max. Negotiated Rate |
$76,113.00 |
| Rate for Payer: Cash Price |
$38,056.50
|
| Rate for Payer: Central Health Plan Commercial |
$67,656.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,828.00
|
| Rate for Payer: Galaxy Health WC |
$71,884.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50,742.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76,113.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,408.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,221.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,914.00
|
| Rate for Payer: Multiplan Commercial |
$63,427.50
|
| Rate for Payer: Networks By Design Commercial |
$54,970.50
|
| Rate for Payer: Prime Health Services Commercial |
$71,884.50
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
OP
|
$5,957.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906811373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$40,548.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,574.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,765.60
|
| Rate for Payer: Cigna of CA PPO |
$4,408.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Media |
$4,906.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,361.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,467.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,095.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: InnovAge PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Riverside University Health System MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
OP
|
$5,957.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906820123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$40,548.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,906.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,574.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,906.54
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,765.60
|
| Rate for Payer: Cigna of CA PPO |
$4,408.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Media |
$4,906.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,361.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,467.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,046.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,095.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: InnovAge PACE Commercial |
$7,359.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,574.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
| Rate for Payer: Prime Health Services Medicare |
$5,200.93
|
| Rate for Payer: Riverside University Health System MISP |
$5,397.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906820123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,191.40 |
| Max. Negotiated Rate |
$5,361.30 |
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,765.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.80
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,361.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.40
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
|
|
HC ICD LEAD REMOVAL, A &/OR V
|
Facility
|
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
906811373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,191.40 |
| Max. Negotiated Rate |
$5,361.30 |
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,765.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.80
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,361.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.40
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
OP
|
$3,787.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906811383
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$10,254.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,218.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,082.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,272.20
|
| 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: Cash Price |
$1,704.15
|
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,029.60
|
| Rate for Payer: Cigna of CA HMO |
$2,423.68
|
| Rate for Payer: Cigna of CA PPO |
$2,802.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,218.95
|
| Rate for Payer: Dignity Health Media |
$3,218.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,218.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,514.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,514.80
|
| Rate for Payer: Galaxy Health WC |
$3,218.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,272.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,408.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,840.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,325.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,525.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$918.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$757.40
|
| Rate for Payer: Multiplan Commercial |
$2,840.25
|
| Rate for Payer: Networks By Design Commercial |
$2,461.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,218.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,514.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,272.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,272.20
|
| 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 Medi-Cal |
$3,218.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,218.95
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
IP
|
$3,787.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906811383
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$757.40 |
| Max. Negotiated Rate |
$3,408.30 |
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,029.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,514.80
|
| Rate for Payer: Galaxy Health WC |
$3,218.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,272.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,408.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,525.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,442.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$757.40
|
| Rate for Payer: Multiplan Commercial |
$2,840.25
|
| Rate for Payer: Networks By Design Commercial |
$2,461.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,218.95
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
IP
|
$3,787.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906820055
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$757.40 |
| Max. Negotiated Rate |
$3,408.30 |
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,029.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,514.80
|
| Rate for Payer: Galaxy Health WC |
$3,218.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,272.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,408.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,525.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,442.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$757.40
|
| Rate for Payer: Multiplan Commercial |
$2,840.25
|
| Rate for Payer: Networks By Design Commercial |
$2,461.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,218.95
|
|
|
HC ICD LEAD(S) TEST @ IMPLANT
|
Facility
|
OP
|
$3,787.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
906820055
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$10,254.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,218.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,082.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,272.20
|
| 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: Cash Price |
$1,704.15
|
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Cash Price |
$1,704.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,029.60
|
| Rate for Payer: Cigna of CA HMO |
$2,423.68
|
| Rate for Payer: Cigna of CA PPO |
$2,802.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,218.95
|
| Rate for Payer: Dignity Health Media |
$3,218.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,218.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,514.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,514.80
|
| Rate for Payer: Galaxy Health WC |
$3,218.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,272.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,408.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,840.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,325.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,525.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$918.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$757.40
|
| Rate for Payer: Multiplan Commercial |
$2,840.25
|
| Rate for Payer: Networks By Design Commercial |
$2,461.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,218.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,514.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,272.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,272.20
|
| 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 Medi-Cal |
$3,218.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,218.95
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
IP
|
$4,436.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906820106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$887.20 |
| Max. Negotiated Rate |
$3,992.40 |
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,548.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,774.40
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,992.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,690.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.20
|
| Rate for Payer: Multiplan Commercial |
$3,327.00
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
OP
|
$4,436.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.07 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,278.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,278.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,661.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,278.49
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,548.80
|
| Rate for Payer: Cigna of CA PPO |
$3,282.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Dignity Health Media |
$2,278.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,506.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,075.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,278.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,278.49
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,992.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,327.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,736.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,759.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,278.49
|
| Rate for Payer: InnovAge PACE Commercial |
$3,417.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,278.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,053.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,053.18
|
| Rate for Payer: Multiplan Commercial |
$3,327.00
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,415.20
|
| Rate for Payer: Riverside University Health System MISP |
$2,506.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,661.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: Vantage Medical Group Senior |
$2,278.49
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
OP
|
$4,436.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906820106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.07 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,278.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,278.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,661.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,278.49
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,548.80
|
| Rate for Payer: Cigna of CA PPO |
$3,282.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Dignity Health Media |
$2,278.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,506.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,075.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,278.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,278.49
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,992.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,327.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,736.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,759.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,278.49
|
| Rate for Payer: InnovAge PACE Commercial |
$3,417.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,278.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,053.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,053.18
|
| Rate for Payer: Multiplan Commercial |
$3,327.00
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,415.20
|
| Rate for Payer: Riverside University Health System MISP |
$2,506.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,661.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: Vantage Medical Group Senior |
$2,278.49
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
IP
|
$4,436.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$887.20 |
| Max. Negotiated Rate |
$3,992.40 |
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,548.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,774.40
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,992.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,690.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.20
|
| Rate for Payer: Multiplan Commercial |
$3,327.00
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$71,347.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,269.40 |
| Max. Negotiated Rate |
$64,212.30 |
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$57,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,538.80
|
| Rate for Payer: Galaxy Health WC |
$60,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$42,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$64,212.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47,588.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27,183.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,269.40
|
| Rate for Payer: Multiplan Commercial |
$53,510.25
|
| Rate for Payer: Networks By Design Commercial |
$46,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$60,644.95
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$71,347.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$595.52 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,450.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,450.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,263.62
|
| Rate for Payer: Blue Distinction Transplant |
$42,808.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$29,450.93
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$57,077.60
|
| Rate for Payer: Cigna of CA PPO |
$52,796.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Dignity Health Media |
$29,450.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,396.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,758.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,450.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,450.93
|
| Rate for Payer: Galaxy Health WC |
$60,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$42,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$64,212.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$53,510.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,299.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,594.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,450.93
|
| Rate for Payer: InnovAge PACE Commercial |
$44,176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47,588.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$595.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,450.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,464.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,464.25
|
| Rate for Payer: Multiplan Commercial |
$53,510.25
|
| Rate for Payer: Multiplan WC |
$40,263.62
|
| Rate for Payer: Networks By Design Commercial |
$46,375.55
|
| Rate for Payer: Preferred Health Network WC |
$41,085.33
|
| Rate for Payer: Prime Health Services Commercial |
$60,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$31,217.99
|
| Rate for Payer: Prime Health Services WC |
$39,852.77
|
| Rate for Payer: Riverside University Health System MISP |
$32,396.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,450.93
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$71,347.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,269.40 |
| Max. Negotiated Rate |
$64,212.30 |
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$57,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,538.80
|
| Rate for Payer: Galaxy Health WC |
$60,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$42,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$64,212.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47,588.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27,183.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,269.40
|
| Rate for Payer: Multiplan Commercial |
$53,510.25
|
| Rate for Payer: Networks By Design Commercial |
$46,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$60,644.95
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$71,347.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$595.52 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,450.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29,450.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,263.62
|
| Rate for Payer: Blue Distinction Transplant |
$42,808.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$29,450.93
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Cash Price |
$32,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$57,077.60
|
| Rate for Payer: Cigna of CA PPO |
$52,796.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Dignity Health Media |
$29,450.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,396.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,758.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,450.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$29,450.93
|
| Rate for Payer: Galaxy Health WC |
$60,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$42,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$64,212.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$53,510.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48,299.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,594.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,450.93
|
| Rate for Payer: InnovAge PACE Commercial |
$44,176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47,588.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$595.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,450.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,464.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,464.25
|
| Rate for Payer: Multiplan Commercial |
$53,510.25
|
| Rate for Payer: Multiplan WC |
$40,263.62
|
| Rate for Payer: Networks By Design Commercial |
$46,375.55
|
| Rate for Payer: Preferred Health Network WC |
$41,085.33
|
| Rate for Payer: Prime Health Services Commercial |
$60,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$31,217.99
|
| Rate for Payer: Prime Health Services WC |
$39,852.77
|
| Rate for Payer: Riverside University Health System MISP |
$32,396.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,176.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,396.02
|
| Rate for Payer: Vantage Medical Group Senior |
$29,450.93
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$95,129.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$617.75 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$41,105.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,196.73
|
| Rate for Payer: Blue Distinction Transplant |
$57,077.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$41,105.24
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$76,103.20
|
| Rate for Payer: Cigna of CA PPO |
$70,395.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$80,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$57,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,616.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71,346.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67,823.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: InnovAge PACE Commercial |
$61,657.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,451.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,025.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,081.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$71,346.75
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$61,833.85
|
| Rate for Payer: Preferred Health Network WC |
$57,343.60
|
| Rate for Payer: Prime Health Services Commercial |
$80,859.65
|
| Rate for Payer: Prime Health Services Medicare |
$43,571.55
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Riverside University Health System MISP |
$45,215.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57,077.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$95,129.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906820217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$617.75 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$41,105.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,196.73
|
| Rate for Payer: Blue Distinction Transplant |
$57,077.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$41,105.24
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Cash Price |
$42,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$76,103.20
|
| Rate for Payer: Cigna of CA PPO |
$70,395.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$80,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$57,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,616.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71,346.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67,823.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: InnovAge PACE Commercial |
$61,657.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,451.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,025.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,081.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$71,346.75
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$61,833.85
|
| Rate for Payer: Preferred Health Network WC |
$57,343.60
|
| Rate for Payer: Prime Health Services Commercial |
$80,859.65
|
| Rate for Payer: Prime Health Services Medicare |
$43,571.55
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Riverside University Health System MISP |
$45,215.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57,077.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
