|
HC P32 CHROMIC PHOSPHATE PER MCI
|
Facility
|
OP
|
$29,723.00
|
|
|
Service Code
|
CPT A9564
|
| Hospital Charge Code |
909301556
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$998.68 |
| Max. Negotiated Rate |
$26,750.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,775.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,264.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,347.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,347.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,425.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,560.86
|
| Rate for Payer: Blue Distinction Transplant |
$17,833.80
|
| Rate for Payer: Blue Shield of California Commercial |
$18,368.81
|
| Rate for Payer: Blue Shield of California EPN |
$14,445.38
|
| Rate for Payer: Cash Price |
$13,375.35
|
| Rate for Payer: Cash Price |
$13,375.35
|
| Rate for Payer: Central Health Plan Commercial |
$23,778.40
|
| Rate for Payer: Cigna of CA HMO |
$19,022.72
|
| Rate for Payer: Cigna of CA PPO |
$21,995.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,264.55
|
| Rate for Payer: Dignity Health Media |
$25,264.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,264.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,889.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,889.20
|
| Rate for Payer: Galaxy Health WC |
$25,264.55
|
| Rate for Payer: Global Benefits Group Commercial |
$17,833.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,750.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22,292.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,403.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,825.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$998.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,944.60
|
| Rate for Payer: Multiplan Commercial |
$22,292.25
|
| Rate for Payer: Networks By Design Commercial |
$19,319.95
|
| Rate for Payer: Prime Health Services Commercial |
$25,264.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,889.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,833.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,833.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,861.50
|
| Rate for Payer: United Healthcare All Other HMO |
$14,861.50
|
| Rate for Payer: United Healthcare HMO Rider |
$14,861.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,861.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$25,264.55
|
|
|
HC P32 SODIUM PHOSPHATE PER MCI
|
Facility
|
IP
|
$5,150.00
|
|
|
Service Code
|
CPT A9563
|
| Hospital Charge Code |
909301555
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,030.00 |
| Max. Negotiated Rate |
$4,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$3,862.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,750.10
|
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,060.00
|
| Rate for Payer: Galaxy Health WC |
$4,377.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,635.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,435.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,962.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,030.00
|
| Rate for Payer: Multiplan Commercial |
$3,862.50
|
| Rate for Payer: Networks By Design Commercial |
$3,347.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,377.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,944.64
|
| Rate for Payer: United Healthcare All Other HMO |
$1,899.32
|
| Rate for Payer: United Healthcare HMO Rider |
$1,858.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,699.50
|
|
|
HC P32 SODIUM PHOSPHATE PER MCI
|
Facility
|
OP
|
$5,150.00
|
|
|
Service Code
|
CPT A9563
|
| Hospital Charge Code |
909301555
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$140.81 |
| Max. Negotiated Rate |
$4,635.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,863.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,377.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,832.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,832.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.17
|
| Rate for Payer: Blue Distinction Transplant |
$3,090.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,182.70
|
| Rate for Payer: Blue Shield of California EPN |
$2,502.90
|
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,120.00
|
| Rate for Payer: Cigna of CA HMO |
$3,296.00
|
| Rate for Payer: Cigna of CA PPO |
$3,811.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,377.50
|
| Rate for Payer: Dignity Health Media |
$4,377.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,377.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,060.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,060.00
|
| Rate for Payer: Galaxy Health WC |
$4,377.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,635.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,862.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,802.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,435.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,030.00
|
| Rate for Payer: Multiplan Commercial |
$3,862.50
|
| Rate for Payer: Networks By Design Commercial |
$3,347.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,377.50
|
| Rate for Payer: Riverside University Health System MISP |
$2,060.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,090.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,090.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,575.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,575.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,575.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,377.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,377.50
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
|
OP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906811421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$553.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: Blue Distinction Transplant |
$16,405.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Central Health Plan Commercial |
$21,874.40
|
| Rate for Payer: Cigna of CA PPO |
$20,233.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,608.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,507.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,170.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: InnovAge PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$553.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,468.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Riverside University Health System MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,405.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
|
OP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906820254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$553.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: Blue Distinction Transplant |
$16,405.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Central Health Plan Commercial |
$21,874.40
|
| Rate for Payer: Cigna of CA PPO |
$20,233.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,608.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,507.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,170.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: InnovAge PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$553.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,468.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Riverside University Health System MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,405.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
|
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906811421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,468.60 |
| Max. Negotiated Rate |
$24,608.70 |
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Central Health Plan Commercial |
$21,874.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,937.20
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,608.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,417.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,468.60
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
|
|
HC PACE INSERT EXIST MULT HC LEADS
|
Facility
|
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
906820254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,468.60 |
| Max. Negotiated Rate |
$24,608.70 |
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Central Health Plan Commercial |
$21,874.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,937.20
|
| Rate for Payer: Galaxy Health WC |
$23,241.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16,405.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,608.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,237.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,417.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,468.60
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
| Rate for Payer: Networks By Design Commercial |
$17,772.95
|
| Rate for Payer: Prime Health Services Commercial |
$23,241.55
|
|
|
HC PACEMAKER INSERTION KIT
|
Facility
|
OP
|
$508.97
|
|
| Hospital Charge Code |
901698281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.79 |
| Max. Negotiated Rate |
$458.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$309.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$432.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$279.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$279.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$300.70
|
| Rate for Payer: Blue Distinction Transplant |
$305.38
|
| Rate for Payer: Blue Shield of California Commercial |
$320.14
|
| Rate for Payer: Blue Shield of California EPN |
$248.89
|
| Rate for Payer: Cash Price |
$229.04
|
| Rate for Payer: Central Health Plan Commercial |
$407.18
|
| Rate for Payer: Cigna of CA HMO |
$325.74
|
| Rate for Payer: Cigna of CA PPO |
$376.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$432.62
|
| Rate for Payer: Dignity Health Media |
$432.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$432.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$203.59
|
| Rate for Payer: Galaxy Health WC |
$432.62
|
| Rate for Payer: Global Benefits Group Commercial |
$305.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$381.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$178.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$193.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.79
|
| Rate for Payer: Multiplan Commercial |
$381.73
|
| Rate for Payer: Networks By Design Commercial |
$330.83
|
| Rate for Payer: Prime Health Services Commercial |
$432.62
|
| Rate for Payer: Riverside University Health System MISP |
$203.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$254.48
|
| Rate for Payer: United Healthcare All Other HMO |
$254.48
|
| Rate for Payer: United Healthcare HMO Rider |
$254.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$432.62
|
| Rate for Payer: Vantage Medical Group Senior |
$432.62
|
|
|
HC PACEMAKER INSERTION KIT
|
Facility
|
IP
|
$508.97
|
|
| Hospital Charge Code |
901698281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.79 |
| Max. Negotiated Rate |
$458.07 |
| Rate for Payer: Cash Price |
$229.04
|
| Rate for Payer: Central Health Plan Commercial |
$407.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.59
|
| Rate for Payer: Galaxy Health WC |
$432.62
|
| Rate for Payer: Global Benefits Group Commercial |
$305.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$193.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.79
|
| Rate for Payer: Multiplan Commercial |
$381.73
|
| Rate for Payer: Networks By Design Commercial |
$330.83
|
| Rate for Payer: Prime Health Services Commercial |
$432.62
|
|
|
HC PACE MAKER MODEL KIT
|
Facility
|
OP
|
$265.44
|
|
| Hospital Charge Code |
901698277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$238.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$161.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$145.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.82
|
| Rate for Payer: Blue Distinction Transplant |
$159.26
|
| Rate for Payer: Blue Shield of California Commercial |
$166.96
|
| Rate for Payer: Blue Shield of California EPN |
$129.80
|
| Rate for Payer: Cash Price |
$119.45
|
| Rate for Payer: Central Health Plan Commercial |
$212.35
|
| Rate for Payer: Cigna of CA HMO |
$169.88
|
| Rate for Payer: Cigna of CA PPO |
$196.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.62
|
| Rate for Payer: Dignity Health Media |
$225.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.18
|
| Rate for Payer: Galaxy Health WC |
$225.62
|
| Rate for Payer: Global Benefits Group Commercial |
$159.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$199.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.09
|
| Rate for Payer: Multiplan Commercial |
$199.08
|
| Rate for Payer: Networks By Design Commercial |
$172.54
|
| Rate for Payer: Prime Health Services Commercial |
$225.62
|
| Rate for Payer: Riverside University Health System MISP |
$106.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$132.72
|
| Rate for Payer: United Healthcare HMO Rider |
$132.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.62
|
| Rate for Payer: Vantage Medical Group Senior |
$225.62
|
|
|
HC PACE MAKER MODEL KIT
|
Facility
|
IP
|
$265.44
|
|
| Hospital Charge Code |
901698277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$238.90 |
| Rate for Payer: Cash Price |
$119.45
|
| Rate for Payer: Central Health Plan Commercial |
$212.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.18
|
| Rate for Payer: Galaxy Health WC |
$225.62
|
| Rate for Payer: Global Benefits Group Commercial |
$159.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.09
|
| Rate for Payer: Multiplan Commercial |
$199.08
|
| Rate for Payer: Networks By Design Commercial |
$172.54
|
| Rate for Payer: Prime Health Services Commercial |
$225.62
|
|
|
HC PACE MED MICRA TC SYS MC1VRO1
|
Facility
|
OP
|
$25,000.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813823
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,105.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,770.00
|
| Rate for Payer: Blue Distinction Transplant |
$15,000.00
|
| Rate for Payer: Blue Shield of California Commercial |
$18,750.00
|
| Rate for Payer: Blue Shield of California EPN |
$13,600.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Media |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18,750.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,750.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,500.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,500.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,500.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,500.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC PACE MED MICRA TC SYS MC1VRO1
|
Facility
|
IP
|
$25,000.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
906813823
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Blue Shield of California EPN |
$13,350.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$17,500.00
|
| Rate for Payer: Cigna of CA PPO |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$12,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,440.00
|
| Rate for Payer: United Healthcare All Other HMO |
$9,220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,020.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,250.00
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,530.80 |
| Max. Negotiated Rate |
$24,888.60 |
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Central Health Plan Commercial |
$22,123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,061.60
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,888.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,536.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.80
|
| Rate for Payer: Multiplan Commercial |
$20,740.50
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906820213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,530.80 |
| Max. Negotiated Rate |
$24,888.60 |
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Central Health Plan Commercial |
$22,123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,061.60
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,888.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,536.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.80
|
| Rate for Payer: Multiplan Commercial |
$20,740.50
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906811419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$550.60 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,341.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,240.12
|
| Rate for Payer: Blue Distinction Transplant |
$16,592.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$13,341.78
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Central Health Plan Commercial |
$22,123.20
|
| Rate for Payer: Cigna of CA PPO |
$20,463.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,888.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,740.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,880.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,013.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: InnovAge PACE Commercial |
$20,012.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,877.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$20,740.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Preferred Health Network WC |
$18,612.37
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,142.29
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Riverside University Health System MISP |
$14,675.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,592.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACE REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$27,654.00
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
906820213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$550.60 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,341.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,240.12
|
| Rate for Payer: Blue Distinction Transplant |
$16,592.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$13,341.78
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Cash Price |
$12,444.30
|
| Rate for Payer: Central Health Plan Commercial |
$22,123.20
|
| Rate for Payer: Cigna of CA PPO |
$20,463.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$23,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,592.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,888.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,740.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,880.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,013.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: InnovAge PACE Commercial |
$20,012.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,445.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,877.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$20,740.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$17,975.10
|
| Rate for Payer: Preferred Health Network WC |
$18,612.37
|
| Rate for Payer: Prime Health Services Commercial |
$23,505.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,142.29
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Riverside University Health System MISP |
$14,675.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,592.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.81 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: Blue Distinction Transplant |
$19,290.00
|
| 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 |
$24,345.49
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Central Health Plan Commercial |
$25,720.00
|
| Rate for Payer: Cigna of CA PPO |
$23,791.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,935.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,112.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,170.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: InnovAge PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,430.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Riverside University Health System MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,290.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.81 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: Blue Distinction Transplant |
$19,290.00
|
| 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 |
$24,345.49
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Central Health Plan Commercial |
$25,720.00
|
| Rate for Payer: Cigna of CA PPO |
$23,791.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Media |
$24,345.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,935.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,112.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,170.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: InnovAge PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,430.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Riverside University Health System MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,290.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,430.00 |
| Max. Negotiated Rate |
$28,935.00 |
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Central Health Plan Commercial |
$25,720.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,860.00
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,935.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,249.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,430.00
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,430.00 |
| Max. Negotiated Rate |
$28,935.00 |
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Central Health Plan Commercial |
$25,720.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,860.00
|
| Rate for Payer: Galaxy Health WC |
$27,327.50
|
| Rate for Payer: Global Benefits Group Commercial |
$19,290.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,935.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,444.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,249.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,430.00
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
| Rate for Payer: Networks By Design Commercial |
$20,897.50
|
| Rate for Payer: Prime Health Services Commercial |
$27,327.50
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$13,639.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$10,614.79
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Central Health Plan Commercial |
$18,186.40
|
| Rate for Payer: Cigna of CA PPO |
$16,822.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,459.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,049.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,546.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$17,049.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,639.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.39 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,614.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,511.92
|
| Rate for Payer: Blue Distinction Transplant |
$13,639.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$10,614.79
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Central Health Plan Commercial |
$18,186.40
|
| Rate for Payer: Cigna of CA PPO |
$16,822.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,459.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,049.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: InnovAge PACE Commercial |
$15,922.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,546.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$17,049.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Preferred Health Network WC |
$14,808.08
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.68
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Riverside University Health System MISP |
$11,676.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,639.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,546.60 |
| Max. Negotiated Rate |
$20,459.70 |
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Central Health Plan Commercial |
$18,186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,093.20
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,459.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,661.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,546.60
|
| Rate for Payer: Multiplan Commercial |
$17,049.75
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,546.60 |
| Max. Negotiated Rate |
$20,459.70 |
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Central Health Plan Commercial |
$18,186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,093.20
|
| Rate for Payer: Galaxy Health WC |
$19,323.05
|
| Rate for Payer: Global Benefits Group Commercial |
$13,639.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,459.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,162.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,661.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,546.60
|
| Rate for Payer: Multiplan Commercial |
$17,049.75
|
| Rate for Payer: Networks By Design Commercial |
$14,776.45
|
| Rate for Payer: Prime Health Services Commercial |
$19,323.05
|
|
