|
HC EPS ATRIAL PACING
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,205.83
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS ATRIAL PACING
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
906811324
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,076.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,235.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,081.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,205.83
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS ATRIAL RECORDING
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
906811320
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,076.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,235.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,081.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$6,606.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$1,321.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,082.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,293.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,089.11
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,195.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$4,954.50
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$6,606.00
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
906811305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,195.69 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,321.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,254.26
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Cash Price |
$2,972.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,195.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.50
|
| Rate for Payer: Multiplan Commercial |
$4,954.50
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
OP
|
$8,841.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$1,768.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,463.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,746.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,472.58
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,600.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,210.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$6,630.75
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS CATH ABLATION OF AV NODE
|
Facility
|
IP
|
$8,841.00
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
906811334
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,600.22 |
| Max. Negotiated Rate |
$6,630.75 |
| Rate for Payer: Adventist Health Commercial |
$1,768.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,693.60
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Cash Price |
$3,978.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,600.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,210.25
|
| Rate for Payer: Multiplan Commercial |
$6,630.75
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$22,965.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$4,593.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,192.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,927.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,215.33
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,156.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,741.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$17,223.75
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$22,965.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
906811303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,156.66 |
| Max. Negotiated Rate |
$17,223.75 |
| Rate for Payer: Adventist Health Commercial |
$4,593.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,789.46
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Cash Price |
$10,334.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,156.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,741.25
|
| Rate for Payer: Multiplan Commercial |
$17,223.75
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
IP
|
$16,323.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,954.46 |
| Max. Negotiated Rate |
$12,242.25 |
| Rate for Payer: Adventist Health Commercial |
$3,264.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,512.01
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,954.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,080.75
|
| Rate for Payer: Multiplan Commercial |
$12,242.25
|
|
|
HC EPS COMP W/O ARRHYTHMIA INDUCT
|
Facility
|
OP
|
$16,323.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
906811349
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$3,264.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,087.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cash Price |
$7,345.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,609.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,103.94
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,954.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,080.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$12,242.25
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
OP
|
$28,896.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,230.18 |
| Max. Negotiated Rate |
$63,873.54 |
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,857.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$33,617.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,886.62
|
| Rate for Payer: Heritage Provider Network Senior |
$41,349.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$63,873.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38,660.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
| 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 |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W PULM VEIN AFIB ABL
|
Facility
|
IP
|
$28,896.00
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
906811448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,230.18 |
| Max. Negotiated Rate |
$21,672.00 |
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,609.02
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,325.00
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
OP
|
$28,896.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,230.18 |
| Max. Negotiated Rate |
$63,873.54 |
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,857.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$33,617.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,886.62
|
| Rate for Payer: Heritage Provider Network Senior |
$41,349.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$63,873.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38,660.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W SVT ABLATION
|
Facility
|
IP
|
$28,896.00
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
906811445
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$21,672.00 |
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,609.02
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
OP
|
$28,896.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,230.18 |
| Max. Negotiated Rate |
$63,873.54 |
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,857.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,617.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,979.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33,617.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$33,617.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,886.62
|
| Rate for Payer: Heritage Provider Network Senior |
$41,349.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,617.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$63,873.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38,660.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45,047.65
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
| 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 |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,426.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,979.42
|
| Rate for Payer: Vantage Medical Group Senior |
$33,617.65
|
|
|
HC EPS COMP W VT ABLATION
|
Facility
|
IP
|
$28,896.00
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
906811446
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$21,672.00 |
| Rate for Payer: Adventist Health Commercial |
$5,779.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,609.02
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Cash Price |
$13,003.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,230.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,224.00
|
| Rate for Payer: Multiplan Commercial |
$21,672.00
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,076.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,235.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,565.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,081.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,926.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,975.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,800.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,205.83
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,076.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,235.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,565.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,081.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,926.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,975.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,800.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,722.56
|
| Rate for Payer: TriValley Medical Group Senior |
$1,565.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,205.83
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$10,363.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$19,060.17 |
| Rate for Payer: Adventist Health Commercial |
$2,072.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,404.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,735.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,031.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,414.70
|
| Rate for Payer: Heritage Provider Network Senior |
$12,338.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$19,060.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,536.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,590.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$7,772.25
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$10,363.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,875.70 |
| Max. Negotiated Rate |
$7,772.25 |
| Rate for Payer: Adventist Health Commercial |
$2,072.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,673.77
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Cash Price |
$4,663.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,590.75
|
| Rate for Payer: Multiplan Commercial |
$7,772.25
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$13,524.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$11,495.40 |
| Rate for Payer: Adventist Health Commercial |
$2,704.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,357.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,495.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,438.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,143.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: Cash Price |
$6,085.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,790.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,495.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,495.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,495.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,979.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,371.36
|
| Rate for Payer: Heritage Provider Network Senior |
$8,371.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$6,450.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,381.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,466.80
|
| Rate for Payer: Multiplan Commercial |
$10,143.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,495.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,495.40
|
| Rate for Payer: Vantage Medical Group Senior |
$11,495.40
|
|
