|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
OP
|
$6,440.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906811328
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,186.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: Dignity Health Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,486.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,986.36
|
| Rate for Payer: Heritage Provider Network Senior |
$1,829.00
|
| Rate for Payer: Humana Medicare |
$1,486.99
|
| Rate for Payer: IEHP Medi-Cal |
$276.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,825.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,754.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,873.61
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,200.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,200.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906820047
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,115.68 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906820047
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,006.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: Dignity Health Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,486.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,815.52
|
| Rate for Payer: Heritage Provider Network Senior |
$1,829.00
|
| Rate for Payer: Humana Medicare |
$1,486.99
|
| Rate for Payer: IEHP Medi-Cal |
$276.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,825.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,754.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,873.61
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,200.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,200.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC EPS ARRHYTHMIA INDUCTION
|
Facility
IP
|
$6,440.00
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
906811328
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,165.64 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
|
|
HC EPS ATRIAL PACING
|
Facility
IP
|
$6,440.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,165.64 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
|
|
HC EPS ATRIAL PACING
|
Facility
OP
|
$6,440.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$136.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,186.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,986.36
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$165.17
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS ATRIAL PACING
|
Facility
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906820043
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$136.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,006.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,815.52
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$165.17
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS ATRIAL PACING
|
Facility
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906820043
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,115.68 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
IP
|
$6,164.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906820040
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,115.68 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
OP
|
$6,164.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906820040
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,232.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$111.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,234.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cash Price |
$2,773.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,006.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,815.52
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$165.17
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$4,623.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
IP
|
$6,440.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,165.64 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
OP
|
$6,440.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,288.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$111.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,424.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cash Price |
$2,898.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,186.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,986.36
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$165.17
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,165.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$4,830.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
IP
|
$7,740.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,400.94 |
| Max. Negotiated Rate |
$5,805.00 |
| Rate for Payer: Adventist Health Commercial |
$1,548.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,317.38
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,400.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,935.00
|
| Rate for Payer: Multiplan Commercial |
$5,805.00
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
IP
|
$8,487.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906820038
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,536.15 |
| Max. Negotiated Rate |
$6,365.25 |
| Rate for Payer: Adventist Health Commercial |
$1,697.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,830.57
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,536.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,121.75
|
| Rate for Payer: Multiplan Commercial |
$6,365.25
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
OP
|
$7,740.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$254.98 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,548.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,317.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Cash Price |
$3,483.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,031.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,791.06
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$254.98
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,400.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,935.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$5,805.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
OP
|
$8,487.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906820038
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$254.98 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$1,697.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,830.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Cash Price |
$3,819.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,516.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,253.45
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$254.98
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,536.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,121.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$6,365.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
IP
|
$11,916.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,156.80 |
| Max. Negotiated Rate |
$8,937.00 |
| Rate for Payer: Adventist Health Commercial |
$2,383.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,186.29
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,979.00
|
| Rate for Payer: Multiplan Commercial |
$8,937.00
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
OP
|
$11,916.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$2,383.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,186.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Cash Price |
$5,362.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,745.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,376.00
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$1,116.51
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,156.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,979.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$8,937.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
OP
|
$10,948.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906820052
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$2,189.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,521.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,116.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,776.81
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$1,116.51
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,981.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$8,211.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
IP
|
$10,948.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906820052
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,981.59 |
| Max. Negotiated Rate |
$8,211.00 |
| Rate for Payer: Adventist Health Commercial |
$2,189.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,521.28
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Cash Price |
$4,926.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,981.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.00
|
| Rate for Payer: Multiplan Commercial |
$8,211.00
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
IP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906820036
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,252.41 |
| Max. Negotiated Rate |
$17,620.50 |
| Rate for Payer: Adventist Health Commercial |
$4,698.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,140.38
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.50
|
| Rate for Payer: Multiplan Commercial |
$17,620.50
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
IP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,252.41 |
| Max. Negotiated Rate |
$17,620.50 |
| Rate for Payer: Adventist Health Commercial |
$4,698.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,140.38
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.50
|
| Rate for Payer: Multiplan Commercial |
$17,620.50
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
OP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$4,698.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,140.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,271.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,542.79
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$1,090.97
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$17,620.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
OP
|
$23,494.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906820036
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$17,728.90 |
| Rate for Payer: Adventist Health Commercial |
$4,698.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,140.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,271.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: Dignity Health Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,542.79
|
| Rate for Payer: Heritage Provider Network Senior |
$11,477.13
|
| Rate for Payer: Humana Medicare |
$9,331.00
|
| Rate for Payer: IEHP Medi-Cal |
$1,090.97
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,728.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,010.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,757.06
|
| Rate for Payer: Multiplan Commercial |
$17,620.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
IP
|
$16,699.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,022.52 |
| Max. Negotiated Rate |
$12,524.25 |
| Rate for Payer: Adventist Health Commercial |
$3,339.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,472.21
|
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: Cash Price |
$7,514.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,022.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,174.75
|
| Rate for Payer: Multiplan Commercial |
$12,524.25
|
|
