|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$30,542.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,108.40 |
| Max. Negotiated Rate |
$27,487.80 |
| Rate for Payer: Adventist Health Commercial |
$6,108.40
|
| Rate for Payer: Cash Price |
$16,798.10
|
| Rate for Payer: Central Health Plan Commercial |
$24,433.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,216.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,216.80
|
| Rate for Payer: Galaxy Health WC |
$25,960.70
|
| Rate for Payer: Global Benefits Group Commercial |
$18,325.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,487.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,371.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,636.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,905.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,108.40
|
| Rate for Payer: Multiplan Commercial |
$22,906.50
|
| Rate for Payer: Networks By Design Commercial |
$19,852.30
|
| Rate for Payer: Prime Health Services Commercial |
$25,960.70
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$30,542.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.68 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$6,108.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,231.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$16,798.10
|
| Rate for Payer: Cash Price |
$16,798.10
|
| Rate for Payer: Cash Price |
$16,798.10
|
| Rate for Payer: Central Health Plan Commercial |
$24,433.60
|
| Rate for Payer: Cigna of CA HMO |
$19,546.88
|
| Rate for Payer: Cigna of CA PPO |
$22,601.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$25,960.70
|
| Rate for Payer: Global Benefits Group Commercial |
$18,325.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,487.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$518.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: InnovAge PACE Commercial |
$36,347.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,371.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,108.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,470.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$22,906.50
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$19,852.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$25,960.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,685.73
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$26,655.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,325.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$21,596.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$478.35 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,319.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Central Health Plan Commercial |
$17,276.80
|
| Rate for Payer: Cigna of CA HMO |
$13,821.44
|
| Rate for Payer: Cigna of CA PPO |
$15,981.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$18,356.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,957.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,436.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,404.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,319.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$16,197.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$14,037.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$18,356.60
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,957.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$18,357.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,671.40 |
| Max. Negotiated Rate |
$16,521.30 |
| Rate for Payer: Adventist Health Commercial |
$3,671.40
|
| Rate for Payer: Cash Price |
$10,096.35
|
| Rate for Payer: Central Health Plan Commercial |
$14,685.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,342.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,342.80
|
| Rate for Payer: Galaxy Health WC |
$15,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,521.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,994.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,362.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,671.40
|
| Rate for Payer: Multiplan Commercial |
$13,767.75
|
| Rate for Payer: Networks By Design Commercial |
$11,932.05
|
| Rate for Payer: Prime Health Services Commercial |
$15,603.45
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$18,357.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$478.35 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$3,671.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$10,096.35
|
| Rate for Payer: Cash Price |
$10,096.35
|
| Rate for Payer: Cash Price |
$10,096.35
|
| Rate for Payer: Central Health Plan Commercial |
$14,685.60
|
| Rate for Payer: Cigna of CA HMO |
$11,748.48
|
| Rate for Payer: Cigna of CA PPO |
$13,584.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$15,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,521.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,671.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$13,767.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$11,932.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$15,603.45
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,014.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$21,596.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,319.20 |
| Max. Negotiated Rate |
$19,436.40 |
| Rate for Payer: Adventist Health Commercial |
$4,319.20
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Central Health Plan Commercial |
$17,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,638.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,638.40
|
| Rate for Payer: Galaxy Health WC |
$18,356.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,957.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,436.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,404.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,228.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,367.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,319.20
|
| Rate for Payer: Multiplan Commercial |
$16,197.00
|
| Rate for Payer: Networks By Design Commercial |
$14,037.40
|
| Rate for Payer: Prime Health Services Commercial |
$18,356.60
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$9,290.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,858.00 |
| Max. Negotiated Rate |
$8,361.00 |
| Rate for Payer: Adventist Health Commercial |
$1,858.00
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,432.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,716.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,716.00
|
| Rate for Payer: Galaxy Health WC |
$7,896.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,574.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,361.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,196.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,539.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,750.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,858.00
|
| Rate for Payer: Multiplan Commercial |
$6,967.50
|
| Rate for Payer: Networks By Design Commercial |
$6,038.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,896.50
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$7,896.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,579.20 |
| Max. Negotiated Rate |
$7,106.40 |
| Rate for Payer: Adventist Health Commercial |
$1,579.20
|
| Rate for Payer: Cash Price |
$4,342.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,158.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,158.40
|
| Rate for Payer: Galaxy Health WC |
$6,711.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,737.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,106.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,266.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,008.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,887.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,579.20
|
| Rate for Payer: Multiplan Commercial |
$5,922.00
|
| Rate for Payer: Networks By Design Commercial |
$5,132.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,711.60
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$7,896.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.67 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,579.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,342.80
|
| Rate for Payer: Cash Price |
$4,342.80
|
| Rate for Payer: Cash Price |
$4,342.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,316.80
|
| Rate for Payer: Cigna of CA HMO |
$5,053.44
|
| Rate for Payer: Cigna of CA PPO |
$5,843.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$6,711.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,737.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,106.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$267.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,266.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,579.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$5,922.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$5,132.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$6,711.60
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,737.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$9,290.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.67 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,858.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,432.00
|
| Rate for Payer: Cigna of CA HMO |
$5,945.60
|
| Rate for Payer: Cigna of CA PPO |
$6,874.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$7,896.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,574.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,361.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$267.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,196.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,858.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$6,967.50
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$6,038.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$7,896.50
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,574.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$22,080.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.18 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,416.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,297.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$12,144.00
|
| Rate for Payer: Cash Price |
$12,144.00
|
| Rate for Payer: Cash Price |
$12,144.00
|
| Rate for Payer: Central Health Plan Commercial |
$17,664.00
|
| Rate for Payer: Cigna of CA HMO |
$14,131.20
|
| Rate for Payer: Cigna of CA PPO |
$16,339.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$18,768.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,248.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,872.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$612.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: InnovAge PACE Commercial |
$19,945.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,727.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,416.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,818.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$16,560.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$14,352.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$18,768.00
|
| Rate for Payer: Prime Health Services Medicare |
$14,095.08
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,626.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,248.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,195.20 |
| Max. Negotiated Rate |
$23,378.40 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Central Health Plan Commercial |
$20,780.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,390.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,390.40
|
| Rate for Payer: Galaxy Health WC |
$22,079.60
|
| Rate for Payer: Global Benefits Group Commercial |
$15,585.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,378.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,325.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,896.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,079.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,195.20
|
| Rate for Payer: Multiplan Commercial |
$19,482.00
|
| Rate for Payer: Networks By Design Commercial |
$16,884.40
|
| Rate for Payer: Prime Health Services Commercial |
$22,079.60
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.18 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,297.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Central Health Plan Commercial |
$20,780.80
|
| Rate for Payer: Cigna of CA HMO |
$16,624.64
|
| Rate for Payer: Cigna of CA PPO |
$19,222.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$22,079.60
|
| Rate for Payer: Global Benefits Group Commercial |
$15,585.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,378.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$612.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: InnovAge PACE Commercial |
$19,945.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,325.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,195.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,818.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$19,482.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$16,884.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$22,079.60
|
| Rate for Payer: Prime Health Services Medicare |
$14,095.08
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,626.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,585.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$22,080.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,416.00 |
| Max. Negotiated Rate |
$19,872.00 |
| Rate for Payer: Adventist Health Commercial |
$4,416.00
|
| Rate for Payer: Cash Price |
$12,144.00
|
| Rate for Payer: Central Health Plan Commercial |
$17,664.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,832.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,832.00
|
| Rate for Payer: Galaxy Health WC |
$18,768.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,248.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,872.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,727.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,412.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,667.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,416.00
|
| Rate for Payer: Multiplan Commercial |
$16,560.00
|
| Rate for Payer: Networks By Design Commercial |
$14,352.00
|
| Rate for Payer: Prime Health Services Commercial |
$18,768.00
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,985.60 |
| Max. Negotiated Rate |
$22,435.20 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Central Health Plan Commercial |
$19,942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,971.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,971.20
|
| Rate for Payer: Galaxy Health WC |
$21,188.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,956.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,435.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,626.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,497.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,430.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,985.60
|
| Rate for Payer: Multiplan Commercial |
$18,696.00
|
| Rate for Payer: Networks By Design Commercial |
$16,203.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,188.80
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$21,189.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,237.80 |
| Max. Negotiated Rate |
$19,070.10 |
| Rate for Payer: Adventist Health Commercial |
$4,237.80
|
| Rate for Payer: Cash Price |
$11,653.95
|
| Rate for Payer: Central Health Plan Commercial |
$16,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,475.60
|
| Rate for Payer: Galaxy Health WC |
$18,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$12,713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,070.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,133.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,073.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,115.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,237.80
|
| Rate for Payer: Multiplan Commercial |
$15,891.75
|
| Rate for Payer: Networks By Design Commercial |
$13,772.85
|
| Rate for Payer: Prime Health Services Commercial |
$18,010.65
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$21,189.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$507.80 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,237.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$11,653.95
|
| Rate for Payer: Cash Price |
$11,653.95
|
| Rate for Payer: Cash Price |
$11,653.95
|
| Rate for Payer: Central Health Plan Commercial |
$16,951.20
|
| Rate for Payer: Cigna of CA HMO |
$13,560.96
|
| Rate for Payer: Cigna of CA PPO |
$15,679.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$18,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$12,713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,070.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$507.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,133.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,237.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$15,891.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$13,772.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$18,010.65
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,713.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$507.80 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Central Health Plan Commercial |
$19,942.40
|
| Rate for Payer: Cigna of CA HMO |
$15,953.92
|
| Rate for Payer: Cigna of CA PPO |
$18,446.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$21,188.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,956.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,435.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$507.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,626.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,985.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$18,696.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$16,203.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$21,188.80
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,956.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,297.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Central Health Plan Commercial |
$21,852.00
|
| Rate for Payer: Cigna of CA HMO |
$17,481.60
|
| Rate for Payer: Cigna of CA PPO |
$20,213.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$23,217.75
|
| Rate for Payer: Global Benefits Group Commercial |
$16,389.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,583.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: InnovAge PACE Commercial |
$19,945.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,219.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,463.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,818.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$20,486.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$17,754.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$23,217.75
|
| Rate for Payer: Prime Health Services Medicare |
$14,095.08
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,626.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,389.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$23,218.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,643.60 |
| Max. Negotiated Rate |
$20,896.20 |
| Rate for Payer: Adventist Health Commercial |
$4,643.60
|
| Rate for Payer: Cash Price |
$12,769.90
|
| Rate for Payer: Central Health Plan Commercial |
$18,574.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,287.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,287.20
|
| Rate for Payer: Galaxy Health WC |
$19,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13,930.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,896.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,486.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,846.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,371.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,643.60
|
| Rate for Payer: Multiplan Commercial |
$17,413.50
|
| Rate for Payer: Networks By Design Commercial |
$15,091.70
|
| Rate for Payer: Prime Health Services Commercial |
$19,735.30
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$23,218.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$4,643.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,297.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$12,769.90
|
| Rate for Payer: Cash Price |
$12,769.90
|
| Rate for Payer: Cash Price |
$12,769.90
|
| Rate for Payer: Central Health Plan Commercial |
$18,574.40
|
| Rate for Payer: Cigna of CA HMO |
$14,859.52
|
| Rate for Payer: Cigna of CA PPO |
$17,181.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$19,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13,930.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,896.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: InnovAge PACE Commercial |
$19,945.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,486.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,643.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,818.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$17,413.50
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$15,091.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$19,735.30
|
| Rate for Payer: Prime Health Services Medicare |
$14,095.08
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,626.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,463.00 |
| Max. Negotiated Rate |
$24,583.50 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Central Health Plan Commercial |
$21,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,926.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,926.00
|
| Rate for Payer: Galaxy Health WC |
$23,217.75
|
| Rate for Payer: Global Benefits Group Commercial |
$16,389.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,583.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,219.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,407.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,907.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,463.00
|
| Rate for Payer: Multiplan Commercial |
$20,486.25
|
| Rate for Payer: Networks By Design Commercial |
$17,754.75
|
| Rate for Payer: Prime Health Services Commercial |
$23,217.75
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$23,956.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.71 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,791.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,297.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.79
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$13,175.80
|
| Rate for Payer: Cash Price |
$13,175.80
|
| Rate for Payer: Cash Price |
$13,175.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,164.80
|
| Rate for Payer: Cigna of CA HMO |
$15,331.84
|
| Rate for Payer: Cigna of CA PPO |
$17,727.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,951.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13,297.25
|
| Rate for Payer: Galaxy Health WC |
$20,362.60
|
| Rate for Payer: Global Benefits Group Commercial |
$14,373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,560.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,807.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,280.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: InnovAge PACE Commercial |
$19,945.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,978.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,297.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,791.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,818.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,818.31
|
| Rate for Payer: Multiplan Commercial |
$17,967.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: Networks By Design Commercial |
$15,571.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Preferred Health Network WC |
$21,619.17
|
| Rate for Payer: Prime Health Services Commercial |
$20,362.60
|
| Rate for Payer: Prime Health Services Medicare |
$14,095.08
|
| Rate for Payer: Prime Health Services WC |
$20,970.59
|
| Rate for Payer: Riverside University Health System MISP |
$14,626.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,373.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,297.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$23,956.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,791.20 |
| Max. Negotiated Rate |
$21,560.40 |
| Rate for Payer: Adventist Health Commercial |
$4,791.20
|
| Rate for Payer: Cash Price |
$13,175.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,582.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,582.40
|
| Rate for Payer: Galaxy Health WC |
$20,362.60
|
| Rate for Payer: Global Benefits Group Commercial |
$14,373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,560.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,978.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,127.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,828.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,791.20
|
| Rate for Payer: Multiplan Commercial |
$17,967.00
|
| Rate for Payer: Networks By Design Commercial |
$15,571.40
|
| Rate for Payer: Prime Health Services Commercial |
$20,362.60
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$28,184.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,636.80 |
| Max. Negotiated Rate |
$25,365.60 |
| Rate for Payer: Adventist Health Commercial |
$5,636.80
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Central Health Plan Commercial |
$22,547.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11,273.60
|
| Rate for Payer: Galaxy Health WC |
$23,956.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,910.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,365.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,798.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,738.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,445.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,636.80
|
| Rate for Payer: Multiplan Commercial |
$21,138.00
|
| Rate for Payer: Networks By Design Commercial |
$18,319.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,956.40
|
|
