|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$31,297.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,664.76 |
| Max. Negotiated Rate |
$23,472.75 |
| Rate for Payer: Adventist Health Commercial |
$6,259.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,155.27
|
| Rate for Payer: Cash Price |
$14,083.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,188.07
|
| Rate for Payer: Heritage Provider Network Senior |
$21,188.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,664.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,824.25
|
| Rate for Payer: Multiplan Commercial |
$23,472.75
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$31,297.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,664.76 |
| Max. Negotiated Rate |
$26,602.45 |
| Rate for Payer: Adventist Health Commercial |
$6,259.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,341.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,602.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,213.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,472.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,435.00
|
| 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 |
$14,083.65
|
| Rate for Payer: Cash Price |
$14,083.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,343.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,602.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,602.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,602.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,372.84
|
| Rate for Payer: Heritage Provider Network Senior |
$19,372.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$14,928.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,664.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,824.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21,907.90
|
| Rate for Payer: Multiplan Commercial |
$23,472.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,602.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,602.45
|
| Rate for Payer: Vantage Medical Group Senior |
$26,602.45
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$12,964.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,346.48 |
| Max. Negotiated Rate |
$9,723.00 |
| Rate for Payer: Adventist Health Commercial |
$2,592.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,348.82
|
| Rate for Payer: Cash Price |
$5,833.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,776.63
|
| Rate for Payer: Heritage Provider Network Senior |
$8,776.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,346.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,241.00
|
| Rate for Payer: Multiplan Commercial |
$9,723.00
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$12,964.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,346.48 |
| Max. Negotiated Rate |
$20,222.71 |
| Rate for Payer: Adventist Health Commercial |
$2,592.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,011.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$5,833.80
|
| Rate for Payer: Cash Price |
$5,833.80
|
| Rate for Payer: Cash Price |
$5,833.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,426.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,643.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,024.72
|
| Rate for Payer: Heritage Provider Network Senior |
$13,091.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20,222.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,346.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,240.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,241.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$9,723.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,707.88
|
| Rate for Payer: TriValley Medical Group Senior |
$11,707.88
|
| 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 |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$12,445.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,252.55 |
| Max. Negotiated Rate |
$9,333.75 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,014.58
|
| Rate for Payer: Cash Price |
$5,600.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,425.26
|
| Rate for Payer: Heritage Provider Network Senior |
$8,425.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,252.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,111.25
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$12,445.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906811354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,252.55 |
| Max. Negotiated Rate |
$20,222.71 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,691.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$5,600.25
|
| Rate for Payer: Cash Price |
$5,600.25
|
| Rate for Payer: Cash Price |
$5,600.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,089.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,643.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,703.45
|
| Rate for Payer: Heritage Provider Network Senior |
$13,091.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20,222.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,252.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,240.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,111.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,707.88
|
| Rate for Payer: TriValley Medical Group Senior |
$11,707.88
|
| 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 |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
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: Aetna of CA Non-Gatekeeper |
$6,677.64
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,019.81
|
| Rate for Payer: Heritage Provider Network Senior |
$7,019.81
|
| Rate for Payer: Kaiser Foundation Hospitals 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 |
$1,876.79 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,408.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$4,666.05
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,739.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,806.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,418.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,911.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9,132.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,876.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,527.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,286.98
|
| Rate for Payer: TriValley Medical Group Senior |
$5,286.98
|
| 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 |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
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: Aetna of CA Non-Gatekeeper |
$6,677.64
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,019.81
|
| Rate for Payer: Heritage Provider Network Senior |
$7,019.81
|
| Rate for Payer: Kaiser Foundation Hospitals 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
|
$10,369.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,876.79 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,073.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,408.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$4,666.05
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Cash Price |
$4,666.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,739.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,806.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,418.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,911.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9,132.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,876.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,527.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,776.75
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,286.98
|
| Rate for Payer: TriValley Medical Group Senior |
$5,286.98
|
| 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 |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
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: Aetna of CA Non-Gatekeeper |
$2,717.04
|
| Rate for Payer: Cash Price |
$1,898.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,856.26
|
| Rate for Payer: Heritage Provider Network Senior |
$2,856.26
|
| Rate for Payer: Kaiser Foundation Hospitals 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
|
$4,219.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.64 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$843.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,607.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$1,898.55
|
| Rate for Payer: Cash Price |
$1,898.55
|
| Rate for Payer: Cash Price |
$1,898.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,742.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,611.56
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$763.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,054.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$3,164.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| 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 |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$4,364.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$789.88 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$872.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,696.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,435.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,836.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.32
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$789.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,091.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$3,273.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| 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 |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Aetna of CA Non-Gatekeeper |
$2,810.42
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,954.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,954.43
|
| Rate for Payer: Kaiser Foundation Hospitals 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
|
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 Non-Gatekeeper |
$5,871.00
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$4,751.90
|
| 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 |
$4,275.00
|
| 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 Medicare Advantage |
$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 Foundation Hospitals Commercial |
$4,531.50
|
| Rate for Payer: Kaiser Foundation Hospitals 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/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 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 |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,118.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| 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 |
$4,275.00
|
| Rate for Payer: Cash Price |
$4,275.00
|
| 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 Foundation Hospitals 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 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 Non-Gatekeeper |
$1,928.16
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$1,560.62
|
| 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 |
$1,404.00
|
| 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 Medicare Advantage |
$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 Foundation Hospitals Commercial |
$1,488.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$564.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 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 |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,009.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| 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 |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| 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 Foundation Hospitals 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 LEECH THERAPY
|
Facility
|
OP
|
$2,160.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
906500660
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$258.05 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,334.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,080.43
|
| 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 |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,404.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| 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 |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,030.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$390.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$283.86
|
| Rate for Payer: TriValley Medical Group Senior |
$258.05
|
| 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 |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
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: Aetna of CA Non-Gatekeeper |
$1,391.04
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,462.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,462.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$390.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
|
|
HC LEFT ATRIAL APPENDAGE CLOSURE
|
Facility
|
OP
|
$59,559.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
906811496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$50,625.15 |
| Rate for Payer: Adventist Health Commercial |
$11,911.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,807.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50,625.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,757.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44,669.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$26,801.55
|
| Rate for Payer: Cash Price |
$26,801.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$38,713.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50,625.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$50,625.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50,625.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,867.02
|
| Rate for Payer: Heritage Provider Network Senior |
$36,867.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28,409.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,780.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,889.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$41,691.30
|
| Rate for Payer: Multiplan Commercial |
$44,669.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50,625.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50,625.15
|
| Rate for Payer: Vantage Medical Group Senior |
$50,625.15
|
|
|
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: Aetna of CA Non-Gatekeeper |
$38,356.00
|
| Rate for Payer: Cash Price |
$26,801.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$40,321.44
|
| Rate for Payer: Heritage Provider Network Senior |
$40,321.44
|
| Rate for Payer: Kaiser Foundation Hospitals 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
|
|
|
HC LEFT HEART CATH BY TRANSSEPTAL
|
Facility
|
IP
|
$10,577.00
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
906811409
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,914.44 |
| Max. Negotiated Rate |
$7,932.75 |
| Rate for Payer: Adventist Health Commercial |
$2,115.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,811.59
|
| Rate for Payer: Cash Price |
$4,759.65
|
| Rate for Payer: Cash Price |
$4,759.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,914.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,644.25
|
| Rate for Payer: Multiplan Commercial |
$7,932.75
|
|
|
HC LEFT HEART CATH BY TRANSSEPTAL
|
Facility
|
OP
|
$10,577.00
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
906811409
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$15,309.00 |
| Rate for Payer: Adventist Health Commercial |
$2,115.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,536.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,990.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,817.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,932.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,759.65
|
| Rate for Payer: Cash Price |
$4,759.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,990.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,990.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,990.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,240.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,547.16
|
| Rate for Payer: Heritage Provider Network Senior |
$6,547.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,045.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,914.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,644.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,403.90
|
| Rate for Payer: Multiplan Commercial |
$7,932.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,990.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,990.45
|
| Rate for Payer: Vantage Medical Group Senior |
$8,990.45
|
|
|
HC LEFT HEART CATH W/WO LV
|
Facility
|
OP
|
$9,166.00
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
906811399
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,659.05 |
| Max. Negotiated Rate |
$12,185.00 |
| Rate for Payer: Adventist Health Commercial |
$1,833.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,664.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$4,124.70
|
| Rate for Payer: Cash Price |
$4,124.70
|
| Rate for Payer: Cash Price |
$4,124.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,407.94
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,169.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,673.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,128.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,922.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,659.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,291.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$6,874.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,300.00
|
| Rate for Payer: TriValley Medical Group Senior |
$3,300.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10,259.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
