|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$25,844.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$470.31 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$5,168.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,754.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$11,629.80
|
| Rate for Payer: Cash Price |
$11,629.80
|
| Rate for Payer: Cash Price |
$11,629.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,798.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,997.44
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$470.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,677.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,461.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$19,383.00
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
OP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$470.31 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$6,430.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,087.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,897.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,900.85
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$470.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,819.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,037.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$32,150.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906820214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,819.15 |
| Max. Negotiated Rate |
$24,112.50 |
| Rate for Payer: Adventist Health Commercial |
$6,430.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,087.05
|
| Rate for Payer: Cash Price |
$14,467.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,765.55
|
| Rate for Payer: Heritage Provider Network Senior |
$21,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,819.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,037.50
|
| Rate for Payer: Multiplan Commercial |
$24,112.50
|
|
|
HC PACE REMV REPL EX MULT LEADS
|
Facility
|
IP
|
$25,844.00
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
906811420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,677.76 |
| Max. Negotiated Rate |
$19,383.00 |
| Rate for Payer: Adventist Health Commercial |
$5,168.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,754.83
|
| Rate for Payer: Cash Price |
$11,629.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,496.39
|
| Rate for Payer: Heritage Provider Network Senior |
$17,496.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,677.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,461.00
|
| Rate for Payer: Multiplan Commercial |
$19,383.00
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$23,148.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,189.79 |
| Max. Negotiated Rate |
$17,361.00 |
| Rate for Payer: Adventist Health Commercial |
$4,629.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,902.68
|
| Rate for Payer: Cash Price |
$10,416.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,671.20
|
| Rate for Payer: Heritage Provider Network Senior |
$15,671.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,189.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,787.00
|
| Rate for Payer: Multiplan Commercial |
$17,361.00
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$23,148.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906811418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.84 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$4,629.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,902.68
|
| 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 |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$10,416.60
|
| Rate for Payer: Cash Price |
$10,416.60
|
| Rate for Payer: Cash Price |
$10,416.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,046.20
|
| 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 |
$14,328.61
|
| 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 |
$433.84
|
| 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 |
$4,189.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,787.00
|
| 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 |
$17,361.00
|
| 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 |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,114.67 |
| Max. Negotiated Rate |
$17,049.75 |
| Rate for Payer: Adventist Health Commercial |
$4,546.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,617.57
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,390.24
|
| Rate for Payer: Heritage Provider Network Senior |
$15,390.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,114.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,683.25
|
| Rate for Payer: Multiplan Commercial |
$17,049.75
|
|
|
HC PACE REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$22,733.00
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
906820212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.84 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$4,546.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,617.57
|
| 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 |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cash Price |
$10,229.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,776.45
|
| 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 |
$14,071.73
|
| 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 |
$433.84
|
| 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 |
$4,114.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,683.25
|
| 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 |
$17,049.75
|
| 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 |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| 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 PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$9,720.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$242.77 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$1,944.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,677.64
|
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$4,374.00
|
| Rate for Payer: Cash Price |
$4,374.00
|
| Rate for Payer: Cash Price |
$4,374.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,318.00
|
| 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 |
$6,016.68
|
| 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 |
$242.77
|
| 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 |
$1,759.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,430.00
|
| 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 |
$7,290.00
|
| 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 |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| 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 PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$9,779.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$242.77 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$1,955.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,718.17
|
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,356.35
|
| 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 |
$6,053.20
|
| 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 |
$242.77
|
| 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 |
$1,770.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,444.75
|
| 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 |
$7,334.25
|
| 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 |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| 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 PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$9,779.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.00 |
| Max. Negotiated Rate |
$7,334.25 |
| Rate for Payer: Adventist Health Commercial |
$1,955.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,718.17
|
| Rate for Payer: Cash Price |
$4,400.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,620.38
|
| Rate for Payer: Heritage Provider Network Senior |
$6,620.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,770.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,444.75
|
| Rate for Payer: Multiplan Commercial |
$7,334.25
|
|
|
HC PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$9,720.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,759.32 |
| Max. Negotiated Rate |
$7,290.00 |
| Rate for Payer: Adventist Health Commercial |
$1,944.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,677.64
|
| Rate for Payer: Cash Price |
$4,374.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,580.44
|
| Rate for Payer: Heritage Provider Network Senior |
$6,580.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,759.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,430.00
|
| Rate for Payer: Multiplan Commercial |
$7,290.00
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$24,301.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$555.24 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$4,860.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,694.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| 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 |
$10,935.45
|
| Rate for Payer: Cash Price |
$10,935.45
|
| Rate for Payer: Cash Price |
$10,935.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,795.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,042.32
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$555.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,398.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,075.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$18,225.75
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,949.08 |
| Max. Negotiated Rate |
$20,507.25 |
| Rate for Payer: Adventist Health Commercial |
$5,468.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,784.64
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,511.21
|
| Rate for Payer: Heritage Provider Network Senior |
$18,511.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,949.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,835.75
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$24,301.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,398.48 |
| Max. Negotiated Rate |
$18,225.75 |
| Rate for Payer: Adventist Health Commercial |
$4,860.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,694.79
|
| Rate for Payer: Cash Price |
$10,935.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,451.78
|
| Rate for Payer: Heritage Provider Network Senior |
$16,451.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,398.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,075.25
|
| Rate for Payer: Multiplan Commercial |
$18,225.75
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$27,343.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$555.24 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,468.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,784.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| 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 |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,772.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,925.32
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$555.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,949.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,835.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$20,087.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,635.75 |
| Max. Negotiated Rate |
$15,065.25 |
| Rate for Payer: Adventist Health Commercial |
$4,017.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,799.77
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,598.90
|
| Rate for Payer: Heritage Provider Network Senior |
$13,598.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,635.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,021.75
|
| Rate for Payer: Multiplan Commercial |
$15,065.25
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$20,087.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$4,017.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,799.77
|
| 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 |
$9,792.00
|
| 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 |
$9,039.15
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,056.55
|
| 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 |
$12,433.85
|
| 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 |
$460.56
|
| 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 |
$3,635.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,021.75
|
| 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 |
$15,065.25
|
| 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 |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| 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 PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$5,248.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,026.88
|
| 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 |
$9,792.00
|
| 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 |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,056.00
|
| 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 |
$16,242.56
|
| 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 |
$460.56
|
| 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 |
$4,749.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,560.00
|
| 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 |
$19,680.00
|
| 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 |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| 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 PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,749.44 |
| Max. Negotiated Rate |
$19,680.00 |
| Rate for Payer: Adventist Health Commercial |
$5,248.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,026.88
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,764.48
|
| Rate for Payer: Heritage Provider Network Senior |
$17,764.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,749.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,560.00
|
| Rate for Payer: Multiplan Commercial |
$19,680.00
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$25,002.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| 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 |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,251.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,476.24
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,161.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,525.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$25,002.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,525.36 |
| Max. Negotiated Rate |
$18,751.50 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,926.35
|
| Rate for Payer: Heritage Provider Network Senior |
$16,926.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,525.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,204.29 |
| Max. Negotiated Rate |
$21,564.75 |
| Rate for Payer: Adventist Health Commercial |
$5,750.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,753.31
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,465.78
|
| Rate for Payer: Heritage Provider Network Senior |
$19,465.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,204.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,188.25
|
| Rate for Payer: Multiplan Commercial |
$21,564.75
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,750.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,753.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| 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 |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,689.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,798.11
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,161.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,204.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,188.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$21,564.75
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$29,667.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,933.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,381.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| 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 |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,283.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,363.87
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,161.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,369.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,416.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$22,250.25
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
