|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$22,330.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,466.00 |
| Max. Negotiated Rate |
$20,097.00 |
| Rate for Payer: Adventist Health Commercial |
$4,466.00
|
| Rate for Payer: Cash Price |
$10,048.50
|
| Rate for Payer: Central Health Plan Commercial |
$17,864.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,631.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,932.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,932.00
|
| Rate for Payer: Galaxy Health WC |
$18,980.50
|
| Rate for Payer: Global Benefits Group Commercial |
$13,398.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,097.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,179.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,174.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,466.00
|
| Rate for Payer: Multiplan Commercial |
$16,747.50
|
| Rate for Payer: Networks By Design Commercial |
$14,514.50
|
| Rate for Payer: Prime Health Services Commercial |
$18,980.50
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$22,330.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.20 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,466.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,443.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$10,048.50
|
| Rate for Payer: Cash Price |
$10,048.50
|
| Rate for Payer: Cash Price |
$10,048.50
|
| Rate for Payer: Central Health Plan Commercial |
$17,864.00
|
| Rate for Payer: Cigna of CA HMO |
$14,291.20
|
| Rate for Payer: Cigna of CA PPO |
$16,524.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,631.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$18,980.50
|
| Rate for Payer: Global Benefits Group Commercial |
$13,398.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,097.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,179.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$550.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,466.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$16,747.50
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$14,514.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$18,980.50
|
| Rate for Payer: Prime Health Services Medicare |
$14,249.59
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,787.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,398.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,165.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$25,961.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.68 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,192.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,773.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$11,682.45
|
| Rate for Payer: Cash Price |
$11,682.45
|
| Rate for Payer: Cash Price |
$11,682.45
|
| Rate for Payer: Central Health Plan Commercial |
$20,768.80
|
| Rate for Payer: Cigna of CA HMO |
$16,615.04
|
| Rate for Payer: Cigna of CA PPO |
$19,211.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,172.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$22,066.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,364.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$518.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,485.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$19,470.75
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$16,874.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$22,066.85
|
| Rate for Payer: Prime Health Services Medicare |
$26,260.17
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$27,251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,576.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,980.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$25,961.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,192.20 |
| Max. Negotiated Rate |
$23,364.90 |
| Rate for Payer: Adventist Health Commercial |
$5,192.20
|
| Rate for Payer: Cash Price |
$11,682.45
|
| Rate for Payer: Central Health Plan Commercial |
$20,768.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,172.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,384.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,384.40
|
| Rate for Payer: Galaxy Health WC |
$22,066.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,364.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,485.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,316.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,192.20
|
| Rate for Payer: Multiplan Commercial |
$19,470.75
|
| Rate for Payer: Networks By Design Commercial |
$16,874.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,066.85
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$18,357.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,671.40 |
| Max. Negotiated Rate |
$16,521.30 |
| Rate for Payer: Adventist Health Commercial |
$3,671.40
|
| Rate for Payer: Cash Price |
$8,260.65
|
| Rate for Payer: Central Health Plan Commercial |
$14,685.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,849.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,342.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,342.80
|
| Rate for Payer: Galaxy Health WC |
$15,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,521.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,656.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,830.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,671.40
|
| Rate for Payer: Multiplan Commercial |
$13,767.75
|
| Rate for Payer: Networks By Design Commercial |
$11,932.05
|
| Rate for Payer: Prime Health Services Commercial |
$15,603.45
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$18,357.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$478.35 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$3,671.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,643.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$8,260.65
|
| Rate for Payer: Cash Price |
$8,260.65
|
| Rate for Payer: Cash Price |
$8,260.65
|
| Rate for Payer: Central Health Plan Commercial |
$14,685.60
|
| Rate for Payer: Cigna of CA HMO |
$11,748.48
|
| Rate for Payer: Cigna of CA PPO |
$13,584.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,849.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$15,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,521.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,656.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$528.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,671.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$13,767.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$11,932.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$15,603.45
|
| Rate for Payer: Prime Health Services Medicare |
$11,282.14
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,707.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,014.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,178.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$7,896.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,579.20 |
| Max. Negotiated Rate |
$7,106.40 |
| Rate for Payer: Adventist Health Commercial |
$1,579.20
|
| Rate for Payer: Cash Price |
$3,553.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,316.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,158.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,158.40
|
| Rate for Payer: Galaxy Health WC |
$6,711.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,737.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,106.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,013.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,658.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,579.20
|
| Rate for Payer: Multiplan Commercial |
$5,922.00
|
| Rate for Payer: Networks By Design Commercial |
$5,132.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,711.60
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$7,896.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.67 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,579.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,643.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,553.20
|
| Rate for Payer: Cash Price |
$3,553.20
|
| Rate for Payer: Cash Price |
$3,553.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,316.80
|
| Rate for Payer: Cigna of CA HMO |
$5,053.44
|
| Rate for Payer: Cigna of CA PPO |
$5,843.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$6,711.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,737.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,106.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$267.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,013.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$295.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,579.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$5,922.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$5,132.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$6,711.60
|
| Rate for Payer: Prime Health Services Medicare |
$11,282.14
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,707.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,737.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,948.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$22,080.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,416.00 |
| Max. Negotiated Rate |
$19,872.00 |
| Rate for Payer: Adventist Health Commercial |
$4,416.00
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Central Health Plan Commercial |
$17,664.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,456.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,832.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,832.00
|
| Rate for Payer: Galaxy Health WC |
$18,768.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,248.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,872.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,020.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,027.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,416.00
|
| Rate for Payer: Multiplan Commercial |
$16,560.00
|
| Rate for Payer: Networks By Design Commercial |
$14,352.00
|
| Rate for Payer: Prime Health Services Commercial |
$18,768.00
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$22,080.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.18 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,416.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,443.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Central Health Plan Commercial |
$17,664.00
|
| Rate for Payer: Cigna of CA HMO |
$14,131.20
|
| Rate for Payer: Cigna of CA PPO |
$16,339.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,456.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$18,768.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,248.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,872.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$612.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,020.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,416.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$16,560.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$14,352.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$18,768.00
|
| Rate for Payer: Prime Health Services Medicare |
$14,249.59
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,787.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,248.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,040.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$21,189.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$507.80 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,237.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,643.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$9,535.05
|
| Rate for Payer: Cash Price |
$9,535.05
|
| Rate for Payer: Cash Price |
$9,535.05
|
| Rate for Payer: Central Health Plan Commercial |
$16,951.20
|
| Rate for Payer: Cigna of CA HMO |
$13,560.96
|
| Rate for Payer: Cigna of CA PPO |
$15,679.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$18,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$12,713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,070.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$507.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,455.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,237.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$15,891.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$13,772.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$18,010.65
|
| Rate for Payer: Prime Health Services Medicare |
$11,282.14
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,707.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,713.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,594.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$21,189.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,237.80 |
| Max. Negotiated Rate |
$19,070.10 |
| Rate for Payer: Adventist Health Commercial |
$4,237.80
|
| Rate for Payer: Cash Price |
$9,535.05
|
| Rate for Payer: Central Health Plan Commercial |
$16,951.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,475.60
|
| Rate for Payer: Galaxy Health WC |
$18,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$12,713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,070.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,455.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,501.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,237.80
|
| Rate for Payer: Multiplan Commercial |
$15,891.75
|
| Rate for Payer: Networks By Design Commercial |
$13,772.85
|
| Rate for Payer: Prime Health Services Commercial |
$18,010.65
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$23,218.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$4,643.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,443.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$10,448.10
|
| Rate for Payer: Cash Price |
$10,448.10
|
| Rate for Payer: Cash Price |
$10,448.10
|
| Rate for Payer: Central Health Plan Commercial |
$18,574.40
|
| Rate for Payer: Cigna of CA HMO |
$14,859.52
|
| Rate for Payer: Cigna of CA PPO |
$17,181.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$19,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13,930.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,896.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,743.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,643.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$17,413.50
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$15,091.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$19,735.30
|
| Rate for Payer: Prime Health Services Medicare |
$14,249.59
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,787.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,609.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$23,218.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,643.60 |
| Max. Negotiated Rate |
$20,896.20 |
| Rate for Payer: Adventist Health Commercial |
$4,643.60
|
| Rate for Payer: Cash Price |
$10,448.10
|
| Rate for Payer: Central Health Plan Commercial |
$18,574.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,287.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,287.20
|
| Rate for Payer: Galaxy Health WC |
$19,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13,930.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,896.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,743.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,698.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,643.60
|
| Rate for Payer: Multiplan Commercial |
$17,413.50
|
| Rate for Payer: Networks By Design Commercial |
$15,091.70
|
| Rate for Payer: Prime Health Services Commercial |
$19,735.30
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$23,956.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,791.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,443.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$10,780.20
|
| Rate for Payer: Cash Price |
$10,780.20
|
| Rate for Payer: Cash Price |
$10,780.20
|
| Rate for Payer: Central Health Plan Commercial |
$19,164.80
|
| Rate for Payer: Cigna of CA HMO |
$15,331.84
|
| Rate for Payer: Cigna of CA PPO |
$17,727.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,769.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$20,362.60
|
| Rate for Payer: Global Benefits Group Commercial |
$14,373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,560.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,212.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,791.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$17,967.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$15,571.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$20,362.60
|
| Rate for Payer: Prime Health Services Medicare |
$14,249.59
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,787.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,373.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,978.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$23,956.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,791.20 |
| Max. Negotiated Rate |
$21,560.40 |
| Rate for Payer: Adventist Health Commercial |
$4,791.20
|
| Rate for Payer: Cash Price |
$10,780.20
|
| Rate for Payer: Central Health Plan Commercial |
$19,164.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,769.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,582.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,582.40
|
| Rate for Payer: Galaxy Health WC |
$20,362.60
|
| Rate for Payer: Global Benefits Group Commercial |
$14,373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,560.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,212.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,134.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,791.20
|
| Rate for Payer: Multiplan Commercial |
$17,967.00
|
| Rate for Payer: Networks By Design Commercial |
$15,571.40
|
| Rate for Payer: Prime Health Services Commercial |
$20,362.60
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
IP
|
$25,215.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,043.00 |
| Max. Negotiated Rate |
$22,693.50 |
| Rate for Payer: Adventist Health Commercial |
$5,043.00
|
| Rate for Payer: Cash Price |
$11,346.75
|
| Rate for Payer: Central Health Plan Commercial |
$20,172.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,650.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,086.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,086.00
|
| Rate for Payer: Galaxy Health WC |
$21,432.75
|
| Rate for Payer: Global Benefits Group Commercial |
$15,129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,693.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,011.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,876.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,043.00
|
| Rate for Payer: Multiplan Commercial |
$18,911.25
|
| Rate for Payer: Networks By Design Commercial |
$16,389.75
|
| Rate for Payer: Prime Health Services Commercial |
$21,432.75
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
OP
|
$25,215.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,043.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,443.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$11,346.75
|
| Rate for Payer: Cash Price |
$11,346.75
|
| Rate for Payer: Cash Price |
$11,346.75
|
| Rate for Payer: Central Health Plan Commercial |
$20,172.00
|
| Rate for Payer: Cigna of CA HMO |
$16,137.60
|
| Rate for Payer: Cigna of CA PPO |
$18,659.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,650.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,180.97
|
| Rate for Payer: EPIC Health Plan Senior |
$14,787.31
|
| Rate for Payer: Galaxy Health WC |
$21,432.75
|
| Rate for Payer: Global Benefits Group Commercial |
$15,129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,693.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,046.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,011.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,820.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,043.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$18,911.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$16,389.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$21,432.75
|
| Rate for Payer: Prime Health Services Medicare |
$14,249.59
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,787.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,607.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,443.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$962.00 |
| Max. Negotiated Rate |
$4,329.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,367.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,924.00
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,054.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,837.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.79 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Cigna of CA HMO |
$3,078.40
|
| Rate for Payer: Cigna of CA PPO |
$3,559.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,367.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$110.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,054.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$122.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,886.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$962.00 |
| Max. Negotiated Rate |
$4,329.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,367.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,924.00
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,054.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,837.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$457.85 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,848.00
|
| Rate for Payer: Cigna of CA HMO |
$3,078.40
|
| Rate for Payer: Cigna of CA PPO |
$3,559.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,367.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$4,088.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,886.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,329.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,054.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$3,126.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$4,088.50
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,886.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
OP
|
$3,582.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.93 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,653.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,703.23
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: Cigna of CA HMO |
$2,292.48
|
| Rate for Payer: Cigna of CA PPO |
$2,650.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,507.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,378.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,919.09
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,352.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$528.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,274.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$584.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,715.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,555.98
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Preferred Health Network WC |
$3,778.81
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,812.94
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,919.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,149.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,791.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,653.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
|
IP
|
$3,582.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$716.40 |
| Max. Negotiated Rate |
$3,223.80 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,507.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,432.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,432.80
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,274.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
|
IP
|
$29,408.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906811362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,881.60 |
| Max. Negotiated Rate |
$26,467.20 |
| Rate for Payer: Adventist Health Commercial |
$5,881.60
|
| Rate for Payer: Cash Price |
$13,233.60
|
| Rate for Payer: Central Health Plan Commercial |
$23,526.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,585.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,763.20
|
| Rate for Payer: EPIC Health Plan Senior |
$11,763.20
|
| Rate for Payer: Galaxy Health WC |
$24,996.80
|
| Rate for Payer: Global Benefits Group Commercial |
$17,644.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,467.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,674.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,350.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,881.60
|
| Rate for Payer: Multiplan Commercial |
$22,056.00
|
| Rate for Payer: Networks By Design Commercial |
$19,115.20
|
| Rate for Payer: Prime Health Services Commercial |
$24,996.80
|
|
