|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
IP
|
$2,004.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$362.72 |
| Max. Negotiated Rate |
$1,503.00 |
| Rate for Payer: Adventist Health Commercial |
$400.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,376.75
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,356.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,356.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.00
|
| Rate for Payer: Multiplan Commercial |
$1,503.00
|
|
|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
OP
|
$2,004.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$362.72 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$400.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,376.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,302.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,356.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,356.71
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$965.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$1,503.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$727.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$669.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
OP
|
$691.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.07 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$138.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$474.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$449.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$467.81
|
| Rate for Payer: Heritage Provider Network Senior |
$467.81
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$333.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$518.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$250.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$230.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
IP
|
$691.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.07 |
| Max. Negotiated Rate |
$518.25 |
| Rate for Payer: Adventist Health Commercial |
$138.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$474.72
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$467.81
|
| Rate for Payer: Heritage Provider Network Senior |
$467.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.75
|
| Rate for Payer: Multiplan Commercial |
$518.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
IP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,925.68 |
| Max. Negotiated Rate |
$41,128.50 |
| Rate for Payer: Adventist Health Commercial |
$10,967.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37,673.71
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,125.33
|
| Rate for Payer: Heritage Provider Network Senior |
$37,125.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,925.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,709.50
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
IP
|
$50,255.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,096.16 |
| Max. Negotiated Rate |
$37,691.25 |
| Rate for Payer: Adventist Health Commercial |
$10,051.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,525.18
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$34,022.64
|
| Rate for Payer: Heritage Provider Network Senior |
$34,022.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,096.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,563.75
|
| Rate for Payer: Multiplan Commercial |
$37,691.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
OP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.18 |
| Max. Negotiated Rate |
$41,128.50 |
| Rate for Payer: Adventist Health Commercial |
$10,967.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37,673.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare 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 |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35,644.70
|
| 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 |
$33,944.72
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$436.18
|
| Rate for Payer: 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 |
$9,925.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,709.50
|
| 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 |
$41,128.50
|
| 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 LEAD INSERT CS, EXIST IMPL
|
Facility
OP
|
$50,255.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.18 |
| Max. Negotiated Rate |
$37,691.25 |
| Rate for Payer: Adventist Health Commercial |
$10,051.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,525.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare 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 |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,665.75
|
| 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 |
$31,107.84
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$436.18
|
| Rate for Payer: 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 |
$9,096.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,563.75
|
| 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 |
$37,691.25
|
| 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 |
$17,865.00
|
| 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 LEAD INSERT CS INITIAL IMPL
|
Facility
OP
|
$57,375.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$48,768.75 |
| Rate for Payer: Adventist Health Commercial |
$11,475.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,416.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$48,768.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31,556.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$43,031.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,293.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,768.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,768.75
|
| Rate for Payer: Dignity Health Senior |
$48,768.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,515.12
|
| Rate for Payer: Heritage Provider Network Senior |
$35,515.12
|
| Rate for Payer: IEHP Medi-Cal |
$403.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,654.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,384.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,343.75
|
| Rate for Payer: Multiplan Commercial |
$43,031.25
|
| 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 Medi-Cal |
$48,768.75
|
| Rate for Payer: Vantage Medical Group Senior |
$48,768.75
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
IP
|
$57,375.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,384.88 |
| Max. Negotiated Rate |
$43,031.25 |
| Rate for Payer: Adventist Health Commercial |
$11,475.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,416.62
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,842.88
|
| Rate for Payer: Heritage Provider Network Senior |
$38,842.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,384.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,343.75
|
| Rate for Payer: Multiplan Commercial |
$43,031.25
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
OP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$42,012.95 |
| Rate for Payer: Adventist Health Commercial |
$9,885.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,956.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42,012.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27,184.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37,070.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,127.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,012.95
|
| Rate for Payer: Dignity Health Senior |
$42,012.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,595.31
|
| Rate for Payer: Heritage Provider Network Senior |
$30,595.31
|
| Rate for Payer: IEHP Medi-Cal |
$403.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23,823.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,946.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,356.75
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| 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 Medi-Cal |
$42,012.95
|
| Rate for Payer: Vantage Medical Group Senior |
$42,012.95
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
IP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,946.29 |
| Max. Negotiated Rate |
$37,070.25 |
| Rate for Payer: Adventist Health Commercial |
$9,885.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,956.35
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,462.08
|
| Rate for Payer: Heritage Provider Network Senior |
$33,462.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,946.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,356.75
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
IP
|
$15,189.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,749.21 |
| Max. Negotiated Rate |
$11,391.75 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,434.84
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,282.95
|
| Rate for Payer: Heritage Provider Network Senior |
$10,282.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,749.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,797.25
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,875.80
|
| 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 |
$10,357.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$98.16
|
| Rate for Payer: 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 |
$3,028.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| 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 |
$12,549.00
|
| 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 |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
OP
|
$15,189.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,434.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,872.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,401.99
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$98.16
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,749.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,797.25
|
| 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 |
$11,391.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,028.49 |
| Max. Negotiated Rate |
$12,549.00 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,327.56
|
| Rate for Payer: Heritage Provider Network Senior |
$11,327.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,028.49 |
| Max. Negotiated Rate |
$12,549.00 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,327.56
|
| Rate for Payer: Heritage Provider Network Senior |
$11,327.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$696.95 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,875.80
|
| 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 |
$10,357.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$696.95
|
| Rate for Payer: 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 |
$3,028.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| 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 |
$12,549.00
|
| 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 |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
OP
|
$14,581.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$696.95 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$2,916.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,017.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,477.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,025.64
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$696.95
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,639.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,645.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$10,935.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
IP
|
$14,581.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,639.16 |
| Max. Negotiated Rate |
$10,935.75 |
| Rate for Payer: Adventist Health Commercial |
$2,916.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,017.15
|
| Rate for Payer: Cash Price |
$6,561.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,871.34
|
| Rate for Payer: Heritage Provider Network Senior |
$9,871.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,639.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,645.25
|
| Rate for Payer: Multiplan Commercial |
$10,935.75
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
IP
|
$12,150.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,199.15 |
| Max. Negotiated Rate |
$9,112.50 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,225.55
|
| Rate for Payer: Heritage Provider Network Senior |
$8,225.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
OP
|
$12,150.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906811361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,897.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,520.85
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: IEHP Medi-Cal |
$460.56
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
IP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,396.08 |
| Max. Negotiated Rate |
$9,928.50 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,962.13
|
| Rate for Payer: Heritage Provider Network Senior |
$8,962.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
|
|
HC LEAD REPAIR DUAL A & V
|
Facility
OP
|
$13,238.00
|
|
|
Service Code
|
CPT 33220
|
| Hospital Charge Code |
906820118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$14,131.19 |
| Rate for Payer: Adventist Health Commercial |
$2,647.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,094.51
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cash Price |
$5,957.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,604.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: Dignity Health Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,906.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,194.32
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: IEHP Medi-Cal |
$460.56
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,322.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,309.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,182.24
|
| Rate for Payer: Multiplan Commercial |
$9,928.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,397.19
|
| Rate for Payer: TriValley Medical Group Senior |
$5,397.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
IP
|
$12,150.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,199.15 |
| Max. Negotiated Rate |
$9,112.50 |
| Rate for Payer: Adventist Health Commercial |
$2,430.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,347.05
|
| Rate for Payer: Cash Price |
$5,467.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,225.55
|
| Rate for Payer: Heritage Provider Network Senior |
$8,225.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,199.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.50
|
| Rate for Payer: Multiplan Commercial |
$9,112.50
|
|
