|
HC PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$9,290.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$1,858.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,382.23
|
| 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 |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,038.50
|
| 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 |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,750.51
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$252.10
|
| 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 |
$1,681.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,322.50
|
| 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 |
$6,967.50
|
| 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 |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| 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 PACER GENERATOR REMOVAL
|
Facility
|
OP
|
$8,296.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906811358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$1,659.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,699.35
|
| 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 |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,562.80
|
| Rate for Payer: Cash Price |
$4,562.80
|
| Rate for Payer: Cash Price |
$4,562.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,392.40
|
| 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 |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,135.22
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$252.10
|
| 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 |
$1,501.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,074.00
|
| 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 |
$6,222.00
|
| 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 |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| 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 PACER GENERATOR REMOVAL
|
Facility
|
IP
|
$9,290.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
906820115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,681.49 |
| Max. Negotiated Rate |
$6,967.50 |
| Rate for Payer: Adventist Health Commercial |
$1,858.00
|
| Rate for Payer: Cash Price |
$5,109.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,289.33
|
| Rate for Payer: Heritage Provider Network Senior |
$6,289.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,681.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,322.50
|
| Rate for Payer: Multiplan Commercial |
$6,967.50
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$20,741.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,754.12 |
| Max. Negotiated Rate |
$15,555.75 |
| Rate for Payer: Adventist Health Commercial |
$4,148.20
|
| Rate for Payer: Cash Price |
$11,407.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,041.66
|
| Rate for Payer: Heritage Provider Network Senior |
$14,041.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,754.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,185.25
|
| Rate for Payer: Multiplan Commercial |
$15,555.75
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,845.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,680.00
|
| 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 |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,884.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,079.14
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$576.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,701.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,494.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$19,482.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
IP
|
$25,976.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,701.66 |
| Max. Negotiated Rate |
$19,482.00 |
| Rate for Payer: Adventist Health Commercial |
$5,195.20
|
| Rate for Payer: Cash Price |
$14,286.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,585.75
|
| Rate for Payer: Heritage Provider Network Senior |
$17,585.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,701.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,494.00
|
| Rate for Payer: Multiplan Commercial |
$19,482.00
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
|
OP
|
$20,741.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$4,148.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,249.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,680.00
|
| 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 |
$11,407.55
|
| Rate for Payer: Cash Price |
$11,407.55
|
| Rate for Payer: Cash Price |
$11,407.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,481.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,838.68
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$576.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,754.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,185.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$15,555.75
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,511.97 |
| Max. Negotiated Rate |
$18,696.00 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,876.26
|
| Rate for Payer: Heritage Provider Network Senior |
$16,876.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,511.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,232.00
|
| Rate for Payer: Multiplan Commercial |
$18,696.00
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
IP
|
$17,144.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,103.06 |
| Max. Negotiated Rate |
$12,858.00 |
| Rate for Payer: Adventist Health Commercial |
$3,428.80
|
| Rate for Payer: Cash Price |
$9,429.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,606.49
|
| Rate for Payer: Heritage Provider Network Senior |
$11,606.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,103.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,286.00
|
| Rate for Payer: Multiplan Commercial |
$12,858.00
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$24,928.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$4,985.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,125.54
|
| 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 |
$10,680.00
|
| 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 |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cash Price |
$13,710.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,203.20
|
| 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 |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,430.43
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$478.27
|
| 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 |
$4,511.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,232.00
|
| 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 |
$18,696.00
|
| 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 |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 PACER INSERT/RPL ONLY, SINGLE
|
Facility
|
OP
|
$17,144.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$3,428.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,777.93
|
| 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 |
$10,680.00
|
| 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 |
$9,429.20
|
| Rate for Payer: Cash Price |
$9,429.20
|
| Rate for Payer: Cash Price |
$9,429.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11,143.60
|
| 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 |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,612.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$478.27
|
| 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 |
$3,103.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,286.00
|
| 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 |
$12,858.00
|
| 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 |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,765.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,754.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,907.99
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,944.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,828.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$20,486.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| 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 |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$21,339.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,862.36 |
| Max. Negotiated Rate |
$16,004.25 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,446.50
|
| Rate for Payer: Heritage Provider Network Senior |
$14,446.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
IP
|
$27,315.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,944.02 |
| Max. Negotiated Rate |
$20,486.25 |
| Rate for Payer: Adventist Health Commercial |
$5,463.00
|
| Rate for Payer: Cash Price |
$15,023.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,492.26
|
| Rate for Payer: Heritage Provider Network Senior |
$18,492.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,944.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,828.75
|
| Rate for Payer: Multiplan Commercial |
$20,486.25
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
|
OP
|
$21,339.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,659.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,870.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,208.84
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| 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 |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$28,184.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$5,636.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,362.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$15,501.20
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,319.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,445.90
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,101.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,046.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$21,138.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$21,339.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,862.36 |
| Max. Negotiated Rate |
$16,004.25 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,446.50
|
| Rate for Payer: Heritage Provider Network Senior |
$14,446.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
OP
|
$21,339.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,659.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,870.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,208.84
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
|
IP
|
$28,184.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,101.30 |
| Max. Negotiated Rate |
$21,138.00 |
| Rate for Payer: Adventist Health Commercial |
$5,636.80
|
| Rate for Payer: Cash Price |
$15,501.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,080.57
|
| Rate for Payer: Heritage Provider Network Senior |
$19,080.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,101.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,046.00
|
| Rate for Payer: Multiplan Commercial |
$21,138.00
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
IP
|
$29,665.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,369.36 |
| Max. Negotiated Rate |
$22,248.75 |
| Rate for Payer: Adventist Health Commercial |
$5,933.00
|
| Rate for Payer: Cash Price |
$16,315.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,083.21
|
| Rate for Payer: Heritage Provider Network Senior |
$20,083.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,369.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,416.25
|
| Rate for Payer: Multiplan Commercial |
$22,248.75
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
IP
|
$21,339.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,862.36 |
| Max. Negotiated Rate |
$16,004.25 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,446.50
|
| Rate for Payer: Heritage Provider Network Senior |
$14,446.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
OP
|
$21,339.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$4,267.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,659.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cash Price |
$11,736.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,870.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,208.84
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,862.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,334.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$16,004.25
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
|
OP
|
$29,665.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,264.78 |
| Rate for Payer: Adventist Health Commercial |
$5,933.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,379.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,297.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$16,315.75
|
| Rate for Payer: Cash Price |
$16,315.75
|
| Rate for Payer: Cash Price |
$16,315.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,282.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,626.98
|
| Rate for Payer: Dignity Health Senior |
$13,297.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,297.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,362.63
|
| Rate for Payer: Heritage Provider Network Senior |
$16,355.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,297.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,264.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,369.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,291.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,416.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,754.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,754.53
|
| Rate for Payer: Multiplan Commercial |
$22,248.75
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,626.98
|
| Rate for Payer: TriValley Medical Group Senior |
$14,626.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,945.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,626.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13,297.25
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,304.47
|
| 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 |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,126.50
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,977.39
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$104.34
|
| 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 |
$870.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| 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 |
$3,607.50
|
| 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 PACER LEAD REMOVE, DUAL A & V
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$3,607.50 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,256.37
|
| Rate for Payer: Heritage Provider Network Senior |
$3,256.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$870.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
|
