|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
IP
|
$24,301.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906811359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,398.48 |
| Max. Negotiated Rate |
$18,225.75 |
| Rate for Payer: Adventist Health Commercial |
$4,860.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,694.79
|
| Rate for Payer: Cash Price |
$10,935.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,451.78
|
| Rate for Payer: Heritage Provider Network Senior |
$16,451.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,398.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,075.25
|
| Rate for Payer: Multiplan Commercial |
$18,225.75
|
|
|
HC PACER INSERT/RPL ONLY, DUAL
|
Facility
IP
|
$27,343.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
906820116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,949.08 |
| Max. Negotiated Rate |
$20,507.25 |
| Rate for Payer: Adventist Health Commercial |
$5,468.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,784.64
|
| Rate for Payer: Cash Price |
$12,304.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,511.21
|
| Rate for Payer: Heritage Provider Network Senior |
$18,511.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,949.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,835.75
|
| Rate for Payer: Multiplan Commercial |
$20,507.25
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
OP
|
$20,087.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$4,017.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,799.77
|
| Rate for Payer: 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 |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,056.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,433.85
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$460.56
|
| 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 |
$3,635.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,021.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$15,065.25
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
IP
|
$20,087.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906811353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,635.75 |
| Max. Negotiated Rate |
$15,065.25 |
| Rate for Payer: Adventist Health Commercial |
$4,017.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,799.77
|
| Rate for Payer: Cash Price |
$9,039.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,598.90
|
| Rate for Payer: Heritage Provider Network Senior |
$13,598.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,635.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,021.75
|
| Rate for Payer: Multiplan Commercial |
$15,065.25
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
IP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,749.44 |
| Max. Negotiated Rate |
$19,680.00 |
| Rate for Payer: Adventist Health Commercial |
$5,248.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,026.88
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,764.48
|
| Rate for Payer: Heritage Provider Network Senior |
$17,764.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,749.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,560.00
|
| Rate for Payer: Multiplan Commercial |
$19,680.00
|
|
|
HC PACER INSERT/RPL ONLY, SINGLE
|
Facility
OP
|
$26,240.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
906820111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.56 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$5,248.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,026.88
|
| Rate for Payer: 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 |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cash Price |
$11,808.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,056.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,242.56
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: IEHP Medi-Cal |
$460.56
|
| 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 |
$4,749.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,560.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$19,680.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
IP
|
$25,002.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,525.36 |
| Max. Negotiated Rate |
$18,751.50 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,926.35
|
| Rate for Payer: Heritage Provider Network Senior |
$16,926.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,525.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
OP
|
$25,002.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906811352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: 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 |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,251.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,476.24
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$4,525.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
OP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,750.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,753.31
|
| Rate for Payer: 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 |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,689.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,798.11
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$5,204.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,188.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$21,564.75
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, W A & V LEAD
|
Facility
IP
|
$28,753.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
906820110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,204.29 |
| Max. Negotiated Rate |
$21,564.75 |
| Rate for Payer: Adventist Health Commercial |
$5,750.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,753.31
|
| Rate for Payer: Cash Price |
$12,938.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,465.78
|
| Rate for Payer: Heritage Provider Network Senior |
$19,465.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,204.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,188.25
|
| Rate for Payer: Multiplan Commercial |
$21,564.75
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
IP
|
$29,667.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,369.73 |
| Max. Negotiated Rate |
$22,250.25 |
| Rate for Payer: Adventist Health Commercial |
$5,933.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,381.23
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,084.56
|
| Rate for Payer: Heritage Provider Network Senior |
$20,084.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,369.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,416.75
|
| Rate for Payer: Multiplan Commercial |
$22,250.25
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
OP
|
$29,667.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906820108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,933.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,381.23
|
| Rate for Payer: 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 |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cash Price |
$13,350.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,283.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,363.87
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$5,369.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,416.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$22,250.25
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
OP
|
$25,002.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: 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 |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,251.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,476.24
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$4,525.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH A-LEAD
|
Facility
IP
|
$25,002.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
906811350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,525.36 |
| Max. Negotiated Rate |
$18,751.50 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,926.35
|
| Rate for Payer: Heritage Provider Network Senior |
$16,926.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,525.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
IP
|
$25,002.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,525.36 |
| Max. Negotiated Rate |
$18,751.50 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,926.35
|
| Rate for Payer: Heritage Provider Network Senior |
$16,926.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,525.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
IP
|
$31,226.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,651.91 |
| Max. Negotiated Rate |
$23,419.50 |
| Rate for Payer: Adventist Health Commercial |
$6,245.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,452.26
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,140.00
|
| Rate for Payer: Heritage Provider Network Senior |
$21,140.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,651.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,806.50
|
| Rate for Payer: Multiplan Commercial |
$23,419.50
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
OP
|
$25,002.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906811351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$5,000.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,176.37
|
| Rate for Payer: 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 |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cash Price |
$11,250.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,251.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,476.24
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$4,525.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,250.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$18,751.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER INSERT/RPL, WITH V-LEAD
|
Facility
OP
|
$31,226.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
906820109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,161.58 |
| Max. Negotiated Rate |
$25,349.38 |
| Rate for Payer: Adventist Health Commercial |
$6,245.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,452.26
|
| 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 |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cash Price |
$14,051.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,296.90
|
| 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 |
$19,328.89
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: IEHP Medi-Cal |
$1,161.58
|
| 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 |
$5,651.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,806.50
|
| 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 |
$23,419.50
|
| 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 |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
IP
|
$12,150.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
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 PACER LEAD REMOVE, DUAL A & V
|
Facility
OP
|
$12,150.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.48 |
| Max. Negotiated Rate |
$9,520.00 |
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| 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 |
$100.48
|
| 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 PACER LEAD REMOVE, DUAL A & V
|
Facility
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906820121
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,078.22 |
| Max. Negotiated Rate |
$4,467.75 |
| Rate for Payer: Adventist Health Commercial |
$1,191.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,092.46
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,032.89
|
| Rate for Payer: Heritage Provider Network Senior |
$4,032.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,078.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.25
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
|
|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
OP
|
$5,957.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906820121
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.48 |
| Max. Negotiated Rate |
$9,520.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,092.46
|
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,872.05
|
| 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 |
$3,687.38
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: IEHP Medi-Cal |
$100.48
|
| 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 |
$1,078.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.25
|
| 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 |
$4,467.75
|
| 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 PACER LEAD REMOVE,SNGL A OR V
|
Facility
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906820120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,078.22 |
| Max. Negotiated Rate |
$4,467.75 |
| Rate for Payer: Adventist Health Commercial |
$1,191.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,092.46
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,032.89
|
| Rate for Payer: Heritage Provider Network Senior |
$4,032.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,078.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.25
|
| Rate for Payer: Multiplan Commercial |
$4,467.75
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
OP
|
$5,957.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906820120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$415.26 |
| Max. Negotiated Rate |
$9,520.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,092.46
|
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,872.05
|
| 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 |
$3,687.38
|
| Rate for Payer: Heritage Provider Network Senior |
$6,035.04
|
| Rate for Payer: Humana Medicare |
$4,906.54
|
| Rate for Payer: IEHP Medi-Cal |
$415.26
|
| 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 |
$1,078.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,789.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.25
|
| 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 |
$4,467.75
|
| 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 PACER LEAD REMOVE,SNGL A OR V
|
Facility
OP
|
$12,150.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$415.26 |
| Max. Negotiated Rate |
$9,520.00 |
| 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 |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| 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 |
$415.26
|
| 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
|
|
