|
HC ICD POCKET REVISION/RELOC
|
Facility
|
IP
|
$3,582.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.34 |
| Max. Negotiated Rate |
$2,686.50 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,425.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,425.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$648.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$895.50
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
|
|
HC ICD POCKET REVISION/RELOC
|
Facility
|
OP
|
$3,582.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
906811336
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,460.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,328.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Senior |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,324.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,217.26
|
| Rate for Payer: Heritage Provider Network Senior |
$2,858.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$119.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,416.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$648.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,672.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$895.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,928.52
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,556.64
|
| Rate for Payer: TriValley Medical Group Senior |
$2,556.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$57,613.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$66,017.00 |
| Rate for Payer: Adventist Health Commercial |
$11,522.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,580.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$31,687.15
|
| Rate for Payer: Cash Price |
$31,687.15
|
| Rate for Payer: Cash Price |
$31,687.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,448.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Senior |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,520.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,662.45
|
| Rate for Payer: Heritage Provider Network Senior |
$35,079.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$507.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54,188.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,427.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,798.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,403.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,935.36
|
| Rate for Payer: Multiplan Commercial |
$43,209.75
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,372.14
|
| Rate for Payer: TriValley Medical Group Senior |
$31,372.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
OP
|
$67,780.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$66,017.00 |
| Rate for Payer: Adventist Health Commercial |
$13,556.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46,564.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$37,279.00
|
| Rate for Payer: Cash Price |
$37,279.00
|
| Rate for Payer: Cash Price |
$37,279.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$44,057.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Senior |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,520.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,955.82
|
| Rate for Payer: Heritage Provider Network Senior |
$35,079.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$507.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54,188.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,268.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,798.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,945.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,935.36
|
| Rate for Payer: Multiplan Commercial |
$50,835.00
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,372.14
|
| Rate for Payer: TriValley Medical Group Senior |
$31,372.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$57,613.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906811423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,427.95 |
| Max. Negotiated Rate |
$43,209.75 |
| Rate for Payer: Adventist Health Commercial |
$11,522.60
|
| Rate for Payer: Cash Price |
$31,687.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,004.00
|
| Rate for Payer: Heritage Provider Network Senior |
$39,004.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,427.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,403.25
|
| Rate for Payer: Multiplan Commercial |
$43,209.75
|
|
|
HC ICD REMV REPL EX DUAL LEADS
|
Facility
|
IP
|
$67,780.00
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
906820216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,268.18 |
| Max. Negotiated Rate |
$50,835.00 |
| Rate for Payer: Adventist Health Commercial |
$13,556.00
|
| Rate for Payer: Cash Price |
$37,279.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$45,887.06
|
| Rate for Payer: Heritage Provider Network Senior |
$45,887.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,268.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,945.00
|
| Rate for Payer: Multiplan Commercial |
$50,835.00
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$62,006.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$12,401.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,598.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$34,103.30
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$40,303.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,381.71
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$526.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,223.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,501.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$46,504.50
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$81,405.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906820217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,734.31 |
| Max. Negotiated Rate |
$61,053.75 |
| Rate for Payer: Adventist Health Commercial |
$16,281.00
|
| Rate for Payer: Cash Price |
$44,772.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$55,111.18
|
| Rate for Payer: Heritage Provider Network Senior |
$55,111.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,734.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,351.25
|
| Rate for Payer: Multiplan Commercial |
$61,053.75
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$81,405.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906820217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$16,281.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$55,925.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$44,772.75
|
| Rate for Payer: Cash Price |
$44,772.75
|
| Rate for Payer: Cash Price |
$44,772.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$52,913.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$50,389.69
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$526.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,734.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,351.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$61,053.75
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC ICD REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$62,006.00
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
906811424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,223.09 |
| Max. Negotiated Rate |
$46,504.50 |
| Rate for Payer: Adventist Health Commercial |
$12,401.20
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,978.06
|
| Rate for Payer: Heritage Provider Network Senior |
$41,978.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,223.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,501.50
|
| Rate for Payer: Multiplan Commercial |
$46,504.50
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$62,006.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$66,017.00 |
| Rate for Payer: Adventist Health Commercial |
$12,401.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,598.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$34,103.30
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$40,303.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Senior |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,520.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,381.71
|
| Rate for Payer: Heritage Provider Network Senior |
$35,079.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$488.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54,188.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,223.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,798.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,501.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,935.36
|
| Rate for Payer: Multiplan Commercial |
$46,504.50
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,372.14
|
| Rate for Payer: TriValley Medical Group Senior |
$31,372.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$62,006.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,223.09 |
| Max. Negotiated Rate |
$46,504.50 |
| Rate for Payer: Adventist Health Commercial |
$12,401.20
|
| Rate for Payer: Cash Price |
$34,103.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,978.06
|
| Rate for Payer: Heritage Provider Network Senior |
$41,978.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,223.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,501.50
|
| Rate for Payer: Multiplan Commercial |
$46,504.50
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$71,168.25 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65,190.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61,679.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Senior |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,520.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$58,737.53
|
| Rate for Payer: Heritage Provider Network Senior |
$35,079.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$488.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54,188.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,175.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,798.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,722.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,935.36
|
| Rate for Payer: Multiplan Commercial |
$71,168.25
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,372.14
|
| Rate for Payer: TriValley Medical Group Senior |
$31,372.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$17,175.27 |
| Max. Negotiated Rate |
$71,168.25 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$64,241.21
|
| Rate for Payer: Heritage Provider Network Senior |
$64,241.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,175.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,722.75
|
| Rate for Payer: Multiplan Commercial |
$71,168.25
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$6,296.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$438.31 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,259.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,365.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,325.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,351.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,462.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,722.00
|
| 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 |
$3,462.80
|
| Rate for Payer: Cash Price |
$3,462.80
|
| Rate for Payer: Cash Price |
$3,462.80
|
| Rate for Payer: Cash Price |
$3,462.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,092.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,351.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,351.60
|
| Rate for Payer: Dignity Health Senior |
$5,351.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,092.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,897.22
|
| Rate for Payer: Heritage Provider Network Senior |
$3,897.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$438.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,003.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,139.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,574.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,407.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,407.20
|
| Rate for Payer: Multiplan Commercial |
$4,722.00
|
| 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 |
$5,351.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,351.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,351.60
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$8,940.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,618.14 |
| Max. Negotiated Rate |
$6,705.00 |
| Rate for Payer: Adventist Health Commercial |
$1,788.00
|
| Rate for Payer: Cash Price |
$4,917.00
|
| Rate for Payer: Cash Price |
$4,917.00
|
| 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 |
$1,618.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,235.00
|
| Rate for Payer: Multiplan Commercial |
$6,705.00
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$6,296.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,139.58 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,259.20
|
| Rate for Payer: Cash Price |
$3,462.80
|
| Rate for Payer: Cash Price |
$3,462.80
|
| 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 |
$1,139.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,574.00
|
| Rate for Payer: Multiplan Commercial |
$4,722.00
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$8,940.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$438.31 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,788.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,778.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,141.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,599.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,917.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,705.00
|
| 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 |
$4,917.00
|
| Rate for Payer: Cash Price |
$4,917.00
|
| Rate for Payer: Cash Price |
$4,917.00
|
| Rate for Payer: Cash Price |
$4,917.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,811.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,599.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,599.00
|
| Rate for Payer: Dignity Health Senior |
$7,599.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,811.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,533.86
|
| Rate for Payer: Heritage Provider Network Senior |
$5,533.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$438.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,264.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,618.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,235.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,258.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,258.00
|
| Rate for Payer: Multiplan Commercial |
$6,705.00
|
| 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 |
$7,599.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,599.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7,599.00
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$820.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$563.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$533.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Senior |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$507.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$555.14
|
| Rate for Payer: Heritage Provider Network Senior |
$555.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$391.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$639.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$639.63
|
| Rate for Payer: Multiplan Commercial |
$615.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$295.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$271.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$820.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$148.42 |
| Max. Negotiated Rate |
$615.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$555.14
|
| Rate for Payer: Heritage Provider Network Senior |
$555.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.00
|
| Rate for Payer: Multiplan Commercial |
$615.00
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$540.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$480.07
|
| Rate for Payer: Blue Shield of California EPN |
$384.06
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$511.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Senior |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$252.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$487.15
|
| Rate for Payer: Heritage Provider Network Senior |
$487.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$176.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$375.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$318.11
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$277.72
|
| Rate for Payer: TriValley Medical Group Senior |
$252.47
|
| 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 |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.45 |
| Max. Negotiated Rate |
$590.25 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.80
|
| Rate for Payer: Heritage Provider Network Senior |
$532.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$540.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$511.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Senior |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$252.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.80
|
| Rate for Payer: Heritage Provider Network Senior |
$532.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$375.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$318.11
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$283.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$260.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$540.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$511.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Senior |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$252.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$487.15
|
| Rate for Payer: Heritage Provider Network Senior |
$310.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$176.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$479.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$318.11
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: TriValley Medical Group Commercial |
$277.72
|
| Rate for Payer: TriValley Medical Group Senior |
$277.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.45 |
| Max. Negotiated Rate |
$590.25 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.80
|
| Rate for Payer: Heritage Provider Network Senior |
$532.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
|
