|
HC L&D LEVEL I OBSERV - INIT 1 HR
|
Facility
|
OP
|
$178.00
|
|
| Hospital Charge Code |
902400380
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$151.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$97.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$97.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$86.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.16
|
| Rate for Payer: Blue Distinction Transplant |
$106.80
|
| Rate for Payer: Blue Shield of California Commercial |
$111.96
|
| Rate for Payer: Blue Shield of California EPN |
$87.04
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Central Health Plan Commercial |
$142.40
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$151.30
|
| Rate for Payer: Dignity Health Media |
$151.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$133.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.60
|
| Rate for Payer: Multiplan Commercial |
$133.50
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Riverside University Health System MISP |
$71.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.30
|
| Rate for Payer: Vantage Medical Group Senior |
$151.30
|
|
|
HC L&D LEVEL IV - 1ST HR
|
Facility
|
OP
|
$6,852.00
|
|
| Hospital Charge Code |
902400056
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,370.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,161.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,824.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,768.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,768.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,317.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,048.16
|
| Rate for Payer: Blue Distinction Transplant |
$4,111.20
|
| 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 |
$3,083.40
|
| Rate for Payer: Cash Price |
$3,083.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,481.60
|
| Rate for Payer: Cigna of CA PPO |
$5,070.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,824.20
|
| Rate for Payer: Dignity Health Media |
$5,824.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,824.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,740.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,740.80
|
| Rate for Payer: Galaxy Health WC |
$5,824.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,166.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,139.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,398.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,570.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,610.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,370.40
|
| Rate for Payer: Multiplan Commercial |
$5,139.00
|
| Rate for Payer: Networks By Design Commercial |
$4,453.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,824.20
|
| Rate for Payer: Riverside University Health System MISP |
$2,740.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,111.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,426.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,824.20
|
| Rate for Payer: Vantage Medical Group Senior |
$5,824.20
|
|
|
HC L&D LEVEL IV - 1ST HR
|
Facility
|
IP
|
$6,852.00
|
|
| Hospital Charge Code |
902400056
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,370.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$3,083.40
|
| Rate for Payer: Cash Price |
$3,083.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,481.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,740.80
|
| Rate for Payer: Galaxy Health WC |
$5,824.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,166.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,570.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,610.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,370.40
|
| Rate for Payer: Multiplan Commercial |
$5,139.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,824.20
|
|
|
HC L&D TREATMENT ROOM
|
Facility
|
IP
|
$369.00
|
|
| Hospital Charge Code |
902400418
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$332.10 |
| Rate for Payer: Cash Price |
$166.05
|
| Rate for Payer: Central Health Plan Commercial |
$295.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.60
|
| Rate for Payer: Galaxy Health WC |
$313.65
|
| Rate for Payer: Global Benefits Group Commercial |
$221.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.80
|
| Rate for Payer: Multiplan Commercial |
$276.75
|
| Rate for Payer: Networks By Design Commercial |
$239.85
|
| Rate for Payer: Prime Health Services Commercial |
$313.65
|
|
|
HC L&D TREATMENT ROOM
|
Facility
|
OP
|
$369.00
|
|
| Hospital Charge Code |
902400418
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$224.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$202.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$178.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.01
|
| Rate for Payer: Blue Distinction Transplant |
$221.40
|
| Rate for Payer: Blue Shield of California Commercial |
$232.10
|
| Rate for Payer: Blue Shield of California EPN |
$180.44
|
| Rate for Payer: Cash Price |
$166.05
|
| Rate for Payer: Cash Price |
$166.05
|
| Rate for Payer: Central Health Plan Commercial |
$295.20
|
| Rate for Payer: Cigna of CA HMO |
$236.16
|
| Rate for Payer: Cigna of CA PPO |
$273.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.65
|
| Rate for Payer: Dignity Health Media |
$313.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$313.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$147.60
|
| Rate for Payer: Galaxy Health WC |
$313.65
|
| Rate for Payer: Global Benefits Group Commercial |
$221.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$276.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.80
|
| Rate for Payer: Multiplan Commercial |
$276.75
|
| Rate for Payer: Networks By Design Commercial |
$239.85
|
| Rate for Payer: Prime Health Services Commercial |
$313.65
|
| Rate for Payer: Riverside University Health System MISP |
$147.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$221.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$221.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$313.65
|
| Rate for Payer: Vantage Medical Group Senior |
$313.65
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.24 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,341.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,240.12
|
| Rate for Payer: Blue Distinction Transplant |
$32,902.80
|
| 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 |
$13,341.78
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Central Health Plan Commercial |
$43,870.40
|
| Rate for Payer: Cigna of CA PPO |
$40,580.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$46,612.30
|
| Rate for Payer: Global Benefits Group Commercial |
$32,902.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$49,354.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41,128.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,880.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,013.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: InnovAge PACE Commercial |
$20,012.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,576.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,967.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,877.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$35,644.70
|
| Rate for Payer: Preferred Health Network WC |
$18,612.37
|
| Rate for Payer: Prime Health Services Commercial |
$46,612.30
|
| Rate for Payer: Prime Health Services Medicare |
$14,142.29
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Riverside University Health System MISP |
$14,675.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,902.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,967.60 |
| Max. Negotiated Rate |
$49,354.20 |
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Central Health Plan Commercial |
$43,870.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,935.20
|
| Rate for Payer: Galaxy Health WC |
$46,612.30
|
| Rate for Payer: Global Benefits Group Commercial |
$32,902.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$49,354.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,576.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,893.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,967.60
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
| Rate for Payer: Networks By Design Commercial |
$35,644.70
|
| Rate for Payer: Prime Health Services Commercial |
$46,612.30
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.24 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,341.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,240.12
|
| Rate for Payer: Blue Distinction Transplant |
$32,902.80
|
| 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 |
$13,341.78
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Central Health Plan Commercial |
$43,870.40
|
| Rate for Payer: Cigna of CA PPO |
$40,580.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$46,612.30
|
| Rate for Payer: Global Benefits Group Commercial |
$32,902.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$49,354.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41,128.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,880.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,013.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: InnovAge PACE Commercial |
$20,012.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,576.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,967.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,877.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$35,644.70
|
| Rate for Payer: Preferred Health Network WC |
$18,612.37
|
| Rate for Payer: Prime Health Services Commercial |
$46,612.30
|
| Rate for Payer: Prime Health Services Medicare |
$14,142.29
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Riverside University Health System MISP |
$14,675.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,902.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,967.60 |
| Max. Negotiated Rate |
$49,354.20 |
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Central Health Plan Commercial |
$43,870.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,935.20
|
| Rate for Payer: Galaxy Health WC |
$46,612.30
|
| Rate for Payer: Global Benefits Group Commercial |
$32,902.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$49,354.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,576.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,893.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,967.60
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
| Rate for Payer: Networks By Design Commercial |
$35,644.70
|
| Rate for Payer: Prime Health Services Commercial |
$46,612.30
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,885.40 |
| Max. Negotiated Rate |
$44,484.30 |
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Central Health Plan Commercial |
$39,541.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,770.80
|
| Rate for Payer: Galaxy Health WC |
$42,012.95
|
| Rate for Payer: Global Benefits Group Commercial |
$29,656.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,484.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,967.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,831.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,885.40
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| Rate for Payer: Networks By Design Commercial |
$32,127.55
|
| Rate for Payer: Prime Health Services Commercial |
$42,012.95
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.86 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,184.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27,184.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$29,656.20
|
| 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: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Central Health Plan Commercial |
$39,541.60
|
| Rate for Payer: Cigna of CA PPO |
$36,575.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Dignity Health Media |
$42,012.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,012.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,770.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$19,770.80
|
| Rate for Payer: Galaxy Health WC |
$42,012.95
|
| Rate for Payer: Global Benefits Group Commercial |
$29,656.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,484.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$37,070.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,299.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,967.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,885.40
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| Rate for Payer: Networks By Design Commercial |
$32,127.55
|
| Rate for Payer: Prime Health Services Commercial |
$42,012.95
|
| Rate for Payer: Riverside University Health System MISP |
$19,770.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,656.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42,012.95
|
| Rate for Payer: Vantage Medical Group Senior |
$42,012.95
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,885.40 |
| Max. Negotiated Rate |
$44,484.30 |
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Central Health Plan Commercial |
$39,541.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,770.80
|
| Rate for Payer: Galaxy Health WC |
$42,012.95
|
| Rate for Payer: Global Benefits Group Commercial |
$29,656.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,484.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,967.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,831.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,885.40
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| Rate for Payer: Networks By Design Commercial |
$32,127.55
|
| Rate for Payer: Prime Health Services Commercial |
$42,012.95
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.86 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,184.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27,184.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$29,656.20
|
| 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: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Central Health Plan Commercial |
$39,541.60
|
| Rate for Payer: Cigna of CA PPO |
$36,575.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Dignity Health Media |
$42,012.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,012.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,770.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$19,770.80
|
| Rate for Payer: Galaxy Health WC |
$42,012.95
|
| Rate for Payer: Global Benefits Group Commercial |
$29,656.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,484.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$37,070.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,299.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,967.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,885.40
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| Rate for Payer: Networks By Design Commercial |
$32,127.55
|
| Rate for Payer: Prime Health Services Commercial |
$42,012.95
|
| Rate for Payer: Riverside University Health System MISP |
$19,770.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,656.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42,012.95
|
| Rate for Payer: Vantage Medical Group Senior |
$42,012.95
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$119.55 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$10,039.20
|
| 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 |
$10,614.79
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: Cigna of CA PPO |
$12,381.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,549.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,039.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,346.40 |
| Max. Negotiated Rate |
$15,058.80 |
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,692.80
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,374.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$119.55 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$10,039.20
|
| 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 |
$10,614.79
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: Cigna of CA PPO |
$12,381.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,549.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,039.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,346.40 |
| Max. Negotiated Rate |
$15,058.80 |
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,692.80
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,374.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.84 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$10,039.20
|
| 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 |
$10,614.79
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: Cigna of CA PPO |
$12,381.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,549.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,039.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,346.40 |
| Max. Negotiated Rate |
$15,058.80 |
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,692.80
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,374.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.84 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$10,039.20
|
| 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 |
$10,614.79
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: Cigna of CA PPO |
$12,381.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,549.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,039.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,346.40 |
| Max. Negotiated Rate |
$15,058.80 |
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,385.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,692.80
|
| Rate for Payer: Galaxy Health WC |
$14,222.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,039.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,058.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,374.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,346.40
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Networks By Design Commercial |
$10,875.80
|
| Rate for Payer: Prime Health Services Commercial |
$14,222.20
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.94 |
| Max. Negotiated Rate |
$19,907.00 |
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,942.80
|
| 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 |
$4,906.54
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Central Health Plan Commercial |
$10,590.40
|
| Rate for Payer: Cigna of CA PPO |
$9,796.12
|
| 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 |
$11,252.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,942.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,914.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,928.50
|
| 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 |
$8,829.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.60
|
| 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 |
$9,928.50
|
| Rate for Payer: Networks By Design Commercial |
$8,604.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,252.30
|
| 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 |
$7,942.80
|
| 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 LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.94 |
| Max. Negotiated Rate |
$19,907.00 |
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,942.80
|
| 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 |
$4,906.54
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Central Health Plan Commercial |
$10,590.40
|
| Rate for Payer: Cigna of CA PPO |
$9,796.12
|
| 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 |
$11,252.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,942.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,914.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,928.50
|
| 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 |
$8,829.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.60
|
| 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 |
$9,928.50
|
| Rate for Payer: Networks By Design Commercial |
$8,604.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,252.30
|
| 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 |
$7,942.80
|
| 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 LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,647.60 |
| Max. Negotiated Rate |
$11,914.20 |
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Central Health Plan Commercial |
$10,590.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,295.20
|
| Rate for Payer: Galaxy Health WC |
$11,252.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,942.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,914.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,829.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,043.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.60
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
| Rate for Payer: Networks By Design Commercial |
$8,604.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,252.30
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,647.60 |
| Max. Negotiated Rate |
$11,914.20 |
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Central Health Plan Commercial |
$10,590.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,295.20
|
| Rate for Payer: Galaxy Health WC |
$11,252.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,942.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,914.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,829.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,043.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.60
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
| Rate for Payer: Networks By Design Commercial |
$8,604.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,252.30
|
|
