|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$15,895.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,919.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$8,742.25
|
| Rate for Payer: Cash Price |
$8,742.25
|
| Rate for Payer: Cash Price |
$8,742.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,331.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Senior |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,839.00
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$723.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19,979.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,876.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,973.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,249.48
|
| Rate for Payer: Multiplan Commercial |
$11,921.25
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,567.01
|
| Rate for Payer: TriValley Medical Group Senior |
$11,567.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$15,895.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,876.99 |
| Max. Negotiated Rate |
$11,921.25 |
| Rate for Payer: Adventist Health Commercial |
$3,179.00
|
| Rate for Payer: Cash Price |
$8,742.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,760.92
|
| Rate for Payer: Heritage Provider Network Senior |
$10,760.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,876.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,973.75
|
| Rate for Payer: Multiplan Commercial |
$11,921.25
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$12,576.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,639.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,174.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,784.54
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$478.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,276.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,144.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$10,369.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,876.79 |
| Max. Negotiated Rate |
$7,776.75 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,019.81
|
| Rate for Payer: Heritage Provider Network Senior |
$7,019.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,876.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
OP
|
$10,369.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,123.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,739.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,418.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$478.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,876.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
|
IP
|
$12,576.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,276.26 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,513.95
|
| Rate for Payer: Heritage Provider Network Senior |
$8,513.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,276.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,144.00
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$10,369.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,876.79 |
| Max. Negotiated Rate |
$7,776.75 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,019.81
|
| Rate for Payer: Heritage Provider Network Senior |
$7,019.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,876.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$12,576.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,639.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,174.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,784.54
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$341.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,276.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,144.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$12,576.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,276.26 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,513.95
|
| Rate for Payer: Heritage Provider Network Senior |
$8,513.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,276.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,144.00
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$10,369.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,123.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cash Price |
$5,702.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,739.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,418.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$341.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,876.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$4,219.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$843.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,898.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,742.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,611.56
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$763.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,054.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,164.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$4,219.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.64 |
| Max. Negotiated Rate |
$3,164.25 |
| Rate for Payer: Adventist Health Commercial |
$843.80
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,856.26
|
| Rate for Payer: Heritage Provider Network Senior |
$2,856.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$763.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,054.75
|
| Rate for Payer: Multiplan Commercial |
$3,164.25
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$4,964.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$992.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,410.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,226.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,072.72
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$898.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,241.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,723.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$4,964.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$898.48 |
| Max. Negotiated Rate |
$3,723.00 |
| Rate for Payer: Adventist Health Commercial |
$992.80
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,360.63
|
| Rate for Payer: Heritage Provider Network Senior |
$3,360.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$898.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,241.00
|
| Rate for Payer: Multiplan Commercial |
$3,723.00
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$4,364.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$872.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,998.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$2,400.20
|
| Rate for Payer: Cash Price |
$2,400.20
|
| Rate for Payer: Cash Price |
$2,400.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,836.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.32
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$435.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$789.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,091.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,273.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,589.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$2,873.75
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,396.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,234.28
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$435.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$945.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,306.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$945.73 |
| Max. Negotiated Rate |
$3,918.75 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,537.32
|
| Rate for Payer: Heritage Provider Network Senior |
$3,537.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$945.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,306.25
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$4,364.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$789.88 |
| Max. Negotiated Rate |
$3,273.00 |
| Rate for Payer: Adventist Health Commercial |
$872.80
|
| Rate for Payer: Cash Price |
$2,400.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,954.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,954.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$789.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,091.00
|
| Rate for Payer: Multiplan Commercial |
$3,273.00
|
|
|
HC LEAD STJ QUARTET 1458Q
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813741
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,719.50 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,560.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,819.00
|
| Rate for Payer: Blue Shield of California EPN |
$3,819.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,370.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,130.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,398.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,398.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,719.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,375.00
|
| Rate for Payer: Multiplan Commercial |
$7,125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,432.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,145.45
|
|
|
HC LEAD STJ QUARTET 1458Q
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813741
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,719.50 |
| Max. Negotiated Rate |
$8,075.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,560.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,526.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,225.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,125.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,819.00
|
| Rate for Payer: Blue Shield of California EPN |
$3,819.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,370.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,075.00
|
| Rate for Payer: Dignity Health Senior |
$8,075.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,080.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,398.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,398.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,531.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,719.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,375.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,650.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,650.00
|
| Rate for Payer: Multiplan Commercial |
$7,125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,432.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,145.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Senior |
$8,075.00
|
|
|
HC LEAD STJ TENDRIL 2088TC
|
Facility
|
IP
|
$3,120.00
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
906813692
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$564.72 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,497.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,254.24
|
| Rate for Payer: Blue Shield of California EPN |
$1,254.24
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,435.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,444.56
|
| Rate for Payer: Heritage Provider Network Senior |
$1,444.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$564.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,127.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,033.03
|
|
|
HC LEAD STJ TENDRIL 2088TC
|
Facility
|
OP
|
$3,120.00
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
906813692
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$564.72 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,497.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,143.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,716.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,254.24
|
| Rate for Payer: Blue Shield of California EPN |
$1,254.24
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,435.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,652.00
|
| Rate for Payer: Dignity Health Senior |
$2,652.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,996.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,444.56
|
| Rate for Payer: Heritage Provider Network Senior |
$1,444.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,488.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$564.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,184.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,184.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,127.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,033.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,652.00
|
|
|
HC LEECH THERAPY
|
Facility
|
IP
|
$2,160.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$390.96 |
| Max. Negotiated Rate |
$1,620.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,462.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,462.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
|
|
HC LEECH THERAPY
|
Facility
|
OP
|
$2,160.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,483.92
|
| 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: Blue Shield of California Commercial |
$1,317.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,054.08
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,404.00
|
| 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 |
$1,337.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,337.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,030.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| 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 |
$1,620.00
|
| 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 |
$526.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$443.00
|
| 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 LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
IP
|
$59,559.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,780.18 |
| Max. Negotiated Rate |
$44,669.25 |
| Rate for Payer: Adventist Health Commercial |
$11,911.80
|
| Rate for Payer: Cash Price |
$32,757.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$40,321.44
|
| Rate for Payer: Heritage Provider Network Senior |
$40,321.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,780.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,889.75
|
| Rate for Payer: Multiplan Commercial |
$44,669.25
|
|
