|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$14,581.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,639.16 |
| Max. Negotiated Rate |
$10,935.75 |
| Rate for Payer: Adventist Health Commercial |
$2,916.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,017.15
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,871.34
|
| Rate for Payer: Heritage Provider Network Senior |
$9,871.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,639.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,645.25
|
| Rate for Payer: Multiplan Commercial |
$10,935.75
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$14,581.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$696.95 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$2,916.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,017.15
|
| 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 HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,477.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,025.64
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$696.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,639.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,645.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$10,935.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$12,150.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,199.15 |
| Max. Negotiated Rate |
$9,112.50 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,225.55
|
| Rate for Payer: Heritage Provider Network Senior |
$8,225.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$12,150.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,897.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,520.85
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$460.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,396.08 |
| Max. Negotiated Rate |
$9,928.50 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,962.13
|
| Rate for Payer: Heritage Provider Network Senior |
$8,962.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,604.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,194.32
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$460.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.72 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,604.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,194.32
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$12,150.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,199.15 |
| Max. Negotiated Rate |
$9,112.50 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,225.55
|
| Rate for Payer: Heritage Provider Network Senior |
$8,225.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$12,150.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.72 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,897.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,520.85
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,396.08 |
| Max. Negotiated Rate |
$9,928.50 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,962.13
|
| Rate for Payer: Heritage Provider Network Senior |
$8,962.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$8,141.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$47.08 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$1,628.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,592.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$3,663.45
|
| Rate for Payer: Cash Price |
$3,663.45
|
| Rate for Payer: Cash Price |
$3,663.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,291.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,039.28
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,035.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$6,105.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4,380.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$945.72 |
| Max. Negotiated Rate |
$3,918.75 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,589.58
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,537.32
|
| Rate for Payer: Heritage Provider Network Senior |
$3,537.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$945.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,306.25
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$47.08 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,589.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Cash Price |
$2,351.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,396.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,234.28
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$945.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,306.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4,380.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$8,141.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,473.52 |
| Max. Negotiated Rate |
$6,105.75 |
| Rate for Payer: Adventist Health Commercial |
$1,628.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,592.87
|
| Rate for Payer: Cash Price |
$3,663.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,511.46
|
| Rate for Payer: Heritage Provider Network Senior |
$5,511.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,035.25
|
| Rate for Payer: Multiplan Commercial |
$6,105.75
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$995.50 |
| Max. Negotiated Rate |
$4,125.00 |
| Rate for Payer: Adventist Health Commercial |
$1,100.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,778.50
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,723.50
|
| Rate for Payer: Heritage Provider Network Senior |
$3,723.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$995.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,375.00
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$419.36 |
| Max. Negotiated Rate |
$9,520.00 |
| Rate for Payer: Adventist Health Commercial |
$1,100.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,778.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Cash Price |
$2,475.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,575.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,404.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$419.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$995.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,375.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$4,125.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4,380.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,114.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.63 |
| Max. Negotiated Rate |
$3,835.50 |
| Rate for Payer: Adventist Health Commercial |
$1,022.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,513.32
|
| Rate for Payer: Cash Price |
$2,301.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,462.18
|
| Rate for Payer: Heritage Provider Network Senior |
$3,462.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$925.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,278.50
|
| Rate for Payer: Multiplan Commercial |
$3,835.50
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,114.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$419.36 |
| Max. Negotiated Rate |
$9,520.00 |
| Rate for Payer: Adventist Health Commercial |
$1,022.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,513.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$2,301.30
|
| Rate for Payer: Cash Price |
$2,301.30
|
| Rate for Payer: Cash Price |
$2,301.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,324.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,165.57
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$419.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$925.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,278.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$3,835.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4,380.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LEECH THERAPY
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,121.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Blue Shield of California Commercial |
$1,014.09
|
| Rate for Payer: Blue Shield of California EPN |
$958.57
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,061.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: Dignity Health Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$250.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,010.83
|
| Rate for Payer: Heritage Provider Network Senior |
$1,010.83
|
| Rate for Payer: Humana Medicare |
$250.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$475.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$408.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.18
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$275.15
|
| Rate for Payer: TriValley Medical Group Senior |
$250.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$501.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$422.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC LEECH THERAPY
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$295.57 |
| Max. Negotiated Rate |
$1,224.75 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,121.87
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,105.54
|
| Rate for Payer: Heritage Provider Network Senior |
$1,105.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$408.25
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
OP
|
$69,783.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,058.77 |
| Max. Negotiated Rate |
$59,315.55 |
| Rate for Payer: Adventist Health Commercial |
$13,956.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47,940.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59,315.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38,380.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52,337.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,576.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,231.15
|
| Rate for Payer: Blue Shield of California EPN |
$8,793.20
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$45,358.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59,315.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$59,315.55
|
| Rate for Payer: Dignity Health Senior |
$59,315.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$43,195.68
|
| Rate for Payer: Heritage Provider Network Senior |
$43,195.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,058.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$33,635.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,630.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,445.75
|
| Rate for Payer: Multiplan Commercial |
$52,337.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59,315.55
|
| Rate for Payer: Vantage Medical Group Senior |
$59,315.55
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
IP
|
$69,783.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,630.72 |
| Max. Negotiated Rate |
$52,337.25 |
| Rate for Payer: Adventist Health Commercial |
$13,956.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47,940.92
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$47,243.09
|
| Rate for Payer: Heritage Provider Network Senior |
$47,243.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,630.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,445.75
|
| Rate for Payer: Multiplan Commercial |
$52,337.25
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906820337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,891.05 |
| Max. Negotiated Rate |
$61,703.25 |
| Rate for Payer: Adventist Health Commercial |
$16,454.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56,520.18
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$55,697.47
|
| Rate for Payer: Heritage Provider Network Senior |
$55,697.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,891.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,567.75
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906820337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,058.77 |
| Max. Negotiated Rate |
$69,930.35 |
| Rate for Payer: Adventist Health Commercial |
$16,454.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56,520.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61,703.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,576.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,231.15
|
| Rate for Payer: Blue Shield of California EPN |
$8,793.20
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53,476.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: Dignity Health Senior |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$50,925.75
|
| Rate for Payer: Heritage Provider Network Senior |
$50,925.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,058.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$39,654.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,891.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,567.75
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC LEFT HEART CATH BY TRANSSEPTAL
|
Facility
|
IP
|
$12,490.00
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
906820067
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,260.69 |
| Max. Negotiated Rate |
$9,367.50 |
| Rate for Payer: Adventist Health Commercial |
$2,498.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,580.63
|
| Rate for Payer: Cash Price |
$5,620.50
|
| Rate for Payer: Cash Price |
$5,620.50
|
| 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 |
$2,260.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,122.50
|
| Rate for Payer: Multiplan Commercial |
$9,367.50
|
|
