|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
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 SINGLE A OR V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
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 SINGLE A OR V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.37 |
| 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 |
$400.37
|
| 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 SINGLE A OR V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.37 |
| 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 |
$400.37
|
| 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 REPOSITION A OR V
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,045.00 |
| Max. Negotiated Rate |
$4,702.50 |
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,090.00
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,990.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,045.00 |
| Max. Negotiated Rate |
$4,702.50 |
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,090.00
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,990.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.34 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: Cigna of CA PPO |
$3,866.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,918.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.00
|
| 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 |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.34 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: Cigna of CA PPO |
$3,866.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,918.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.00
|
| 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 |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,200.00
|
| Rate for Payer: Galaxy Health WC |
$4,675.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,095.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.00
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
| Rate for Payer: Networks By Design Commercial |
$3,575.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,675.00
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.76 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,300.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,400.00
|
| Rate for Payer: Cigna of CA PPO |
$4,070.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,675.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,950.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,125.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
| Rate for Payer: Networks By Design Commercial |
$3,575.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,675.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,300.00
|
| 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 |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,200.00
|
| Rate for Payer: Galaxy Health WC |
$4,675.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,095.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.00
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
| Rate for Payer: Networks By Design Commercial |
$3,575.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,675.00
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.76 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,300.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,400.00
|
| Rate for Payer: Cigna of CA PPO |
$4,070.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,675.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,950.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,125.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
| Rate for Payer: Networks By Design Commercial |
$3,575.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,675.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,300.00
|
| 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 |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEATHER KAFO-AFO PORX
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT L4100
|
| Hospital Charge Code |
905354100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$87.15 |
| Max. Negotiated Rate |
$224.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$136.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.11
|
| Rate for Payer: Blue Distinction Transplant |
$149.40
|
| Rate for Payer: Blue Shield of California Commercial |
$186.75
|
| Rate for Payer: Blue Shield of California EPN |
$135.46
|
| Rate for Payer: Cash Price |
$112.05
|
| Rate for Payer: Cash Price |
$112.05
|
| Rate for Payer: Central Health Plan Commercial |
$199.20
|
| Rate for Payer: Cigna of CA HMO |
$174.30
|
| Rate for Payer: Cigna of CA PPO |
$174.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.65
|
| Rate for Payer: Dignity Health Media |
$211.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$99.60
|
| Rate for Payer: Galaxy Health WC |
$211.65
|
| Rate for Payer: Global Benefits Group Commercial |
$149.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$224.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$186.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$166.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.09
|
| Rate for Payer: Multiplan Commercial |
$186.75
|
| Rate for Payer: Networks By Design Commercial |
$124.50
|
| Rate for Payer: Prime Health Services Commercial |
$211.65
|
| Rate for Payer: Riverside University Health System MISP |
$99.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.50
|
| Rate for Payer: United Healthcare All Other HMO |
$124.50
|
| Rate for Payer: United Healthcare HMO Rider |
$124.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.65
|
| Rate for Payer: Vantage Medical Group Senior |
$211.65
|
|
|
HC LEATHER KAFO-AFO PORX
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT L4100
|
| Hospital Charge Code |
905354100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$49.80 |
| Max. Negotiated Rate |
$224.10 |
| Rate for Payer: Blue Shield of California EPN |
$132.97
|
| Rate for Payer: Cash Price |
$112.05
|
| Rate for Payer: Central Health Plan Commercial |
$199.20
|
| Rate for Payer: Cigna of CA HMO |
$174.30
|
| Rate for Payer: Cigna of CA PPO |
$174.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$99.60
|
| Rate for Payer: Galaxy Health WC |
$211.65
|
| Rate for Payer: Global Benefits Group Commercial |
$149.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$224.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$166.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.80
|
| Rate for Payer: Multiplan Commercial |
$186.75
|
| Rate for Payer: Networks By Design Commercial |
$124.50
|
| Rate for Payer: Prime Health Services Commercial |
$211.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.02
|
| Rate for Payer: United Healthcare All Other HMO |
$91.83
|
| Rate for Payer: United Healthcare HMO Rider |
$89.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.17
|
|
|
HC LEECHES - WOUND THERAPY, EA
|
Facility
|
OP
|
$137.94
|
|
| Hospital Charge Code |
901605575
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$124.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.49
|
| Rate for Payer: Blue Distinction Transplant |
$82.76
|
| Rate for Payer: Blue Shield of California Commercial |
$86.76
|
| Rate for Payer: Blue Shield of California EPN |
$67.45
|
| Rate for Payer: Cash Price |
$62.07
|
| Rate for Payer: Central Health Plan Commercial |
$110.35
|
| Rate for Payer: Cigna of CA HMO |
$88.28
|
| Rate for Payer: Cigna of CA PPO |
$102.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.25
|
| Rate for Payer: Dignity Health Media |
$117.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$55.18
|
| Rate for Payer: Galaxy Health WC |
$117.25
|
| Rate for Payer: Global Benefits Group Commercial |
$82.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.15
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$103.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.59
|
| Rate for Payer: Multiplan Commercial |
$103.46
|
| Rate for Payer: Networks By Design Commercial |
$89.66
|
| Rate for Payer: Prime Health Services Commercial |
$117.25
|
| Rate for Payer: Riverside University Health System MISP |
$55.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.97
|
| Rate for Payer: United Healthcare All Other HMO |
$68.97
|
| Rate for Payer: United Healthcare HMO Rider |
$68.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.25
|
| Rate for Payer: Vantage Medical Group Senior |
$117.25
|
|
|
HC LEECHES - WOUND THERAPY, EA
|
Facility
|
IP
|
$137.94
|
|
| Hospital Charge Code |
901605575
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$124.15 |
| Rate for Payer: Cash Price |
$62.07
|
| Rate for Payer: Central Health Plan Commercial |
$110.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.18
|
| Rate for Payer: Galaxy Health WC |
$117.25
|
| Rate for Payer: Global Benefits Group Commercial |
$82.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.59
|
| Rate for Payer: Multiplan Commercial |
$103.46
|
| Rate for Payer: Networks By Design Commercial |
$89.66
|
| Rate for Payer: Prime Health Services Commercial |
$117.25
|
|
|
HC LEECH THERAPY
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$964.78
|
| Rate for Payer: Blue Distinction Transplant |
$979.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,027.16
|
| Rate for Payer: Blue Shield of California EPN |
$798.54
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Cigna of CA HMO |
$1,045.12
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,224.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$762.00
|
| Rate for Payer: United Healthcare All Other HMO |
$515.00
|
| Rate for Payer: United Healthcare HMO Rider |
$312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC LEECH THERAPY
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$326.60 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC LEEP
|
Facility
|
OP
|
$6,380.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
904000025
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$556.49 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,828.00
|
| 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 |
$3,906.18
|
| Rate for Payer: Cash Price |
$2,871.00
|
| Rate for Payer: Cash Price |
$2,871.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,104.00
|
| Rate for Payer: Cigna of CA PPO |
$4,721.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Dignity Health Media |
$3,906.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$5,423.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,828.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,742.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,785.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,445.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,906.18
|
| Rate for Payer: InnovAge PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,255.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$556.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$4,785.00
|
| Rate for Payer: Networks By Design Commercial |
$4,147.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,423.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Riverside University Health System MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,828.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC LEEP
|
Facility
|
IP
|
$6,380.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
904000025
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,276.00 |
| Max. Negotiated Rate |
$5,742.00 |
| Rate for Payer: Cash Price |
$2,871.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,104.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,552.00
|
| Rate for Payer: Galaxy Health WC |
$5,423.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,828.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,742.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,255.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,430.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.00
|
| Rate for Payer: Multiplan Commercial |
$4,785.00
|
| Rate for Payer: Networks By Design Commercial |
$4,147.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,423.00
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906820337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,289.53 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Media |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$61,703.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,289.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Riverside University Health System MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,345.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,289.53 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Media |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$61,703.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,289.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Riverside University Health System MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906820337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,345.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC LEFT HEART CATH BY TRANSSEPTAL
|
Facility
|
OP
|
$12,490.00
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
906811409
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$313.77 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,966.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,616.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,869.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,869.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,494.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,620.50
|
| Rate for Payer: Cash Price |
$5,620.50
|
| Rate for Payer: Cash Price |
$5,620.50
|
| Rate for Payer: Central Health Plan Commercial |
$9,992.00
|
| Rate for Payer: Cigna of CA PPO |
$9,242.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,616.50
|
| Rate for Payer: Dignity Health Media |
$10,616.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,616.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,996.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,996.00
|
| Rate for Payer: Galaxy Health WC |
$10,616.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,494.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,241.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,367.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,371.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,330.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,498.00
|
| Rate for Payer: Multiplan Commercial |
$9,367.50
|
| Rate for Payer: Networks By Design Commercial |
$8,118.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,616.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,996.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,494.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,494.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,616.50
|
| Rate for Payer: Vantage Medical Group Senior |
$10,616.50
|
|
