|
HC SOCIDEM PDC 84999
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900915253
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC SOCINN 558 PRF1 GENE
|
Facility
|
OP
|
$2,371.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
900914743
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$312.85 |
| Max. Negotiated Rate |
$2,015.35 |
| Rate for Payer: Vantage Medical Group Senior |
$2,015.35
|
| Rate for Payer: Adventist Health Commercial |
$474.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$312.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,015.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,304.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,778.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,521.47
|
| Rate for Payer: Blue Shield of California Commercial |
$1,093.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,652.59
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Cigna of CA HMO |
$1,517.44
|
| Rate for Payer: Cigna of CA PPO |
$1,754.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,015.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,015.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,015.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,659.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.40
|
| Rate for Payer: EPIC Health Plan Senior |
$948.40
|
| Rate for Payer: Galaxy Health WC |
$2,015.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,422.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,505.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,398.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$569.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,659.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,659.70
|
| Rate for Payer: Multiplan Commercial |
$1,896.80
|
| Rate for Payer: Networks By Design Commercial |
$1,541.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,015.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,422.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,422.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,185.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,185.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,185.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,185.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,015.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,015.35
|
|
|
HC SOCINN 558 PRF1 GENE
|
Facility
|
IP
|
$2,371.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
900914743
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$474.20 |
| Max. Negotiated Rate |
$2,015.35 |
| Rate for Payer: Adventist Health Commercial |
$474.20
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,659.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.40
|
| Rate for Payer: EPIC Health Plan Senior |
$948.40
|
| Rate for Payer: Galaxy Health WC |
$2,015.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,422.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,505.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,398.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$569.04
|
| Rate for Payer: Multiplan Commercial |
$1,896.80
|
| Rate for Payer: Networks By Design Commercial |
$1,541.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,015.35
|
|
|
HC SOCKET INSERT W LOCK MECH
|
Facility
|
OP
|
$1,133.00
|
|
|
Service Code
|
CPT L5673
|
| Hospital Charge Code |
915340556
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$271.92 |
| Max. Negotiated Rate |
$963.05 |
| Rate for Payer: Adventist Health Commercial |
$464.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$963.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$623.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$849.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$685.80
|
| Rate for Payer: Blue Shield of California Commercial |
$574.43
|
| Rate for Payer: Blue Shield of California Commercial |
$871.28
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cigna of CA HMO |
$793.10
|
| Rate for Payer: Cigna of CA PPO |
$793.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$963.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$963.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$963.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$844.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$955.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$668.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$271.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$793.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$793.10
|
| Rate for Payer: Multiplan Commercial |
$906.40
|
| Rate for Payer: Networks By Design Commercial |
$566.50
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$679.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$679.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.21
|
| Rate for Payer: United Healthcare All Other HMO |
$413.88
|
| Rate for Payer: United Healthcare HMO Rider |
$404.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$371.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$963.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$963.05
|
| Rate for Payer: Vantage Medical Group Senior |
$963.05
|
|
|
HC SOCKET INSERT W LOCK MECH
|
Facility
|
IP
|
$1,133.00
|
|
|
Service Code
|
CPT L5673
|
| Hospital Charge Code |
915340556
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$226.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cigna of CA HMO |
$793.10
|
| Rate for Payer: Cigna of CA PPO |
$793.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$668.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$271.92
|
| Rate for Payer: Multiplan Commercial |
$906.40
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.21
|
| Rate for Payer: United Healthcare All Other HMO |
$413.88
|
| Rate for Payer: United Healthcare HMO Rider |
$404.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$371.06
|
|
|
HC SOCKET INSERT W/O LOCK MECH
|
Facility
|
IP
|
$1,133.00
|
|
|
Service Code
|
CPT L5679
|
| Hospital Charge Code |
915340557
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$226.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cigna of CA HMO |
$793.10
|
| Rate for Payer: Cigna of CA PPO |
$793.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$668.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$271.92
|
| Rate for Payer: Multiplan Commercial |
$906.40
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.21
|
| Rate for Payer: United Healthcare All Other HMO |
$413.88
|
| Rate for Payer: United Healthcare HMO Rider |
$404.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$371.06
|
|
|
HC SOCKET INSERT W/O LOCK MECH
|
Facility
|
OP
|
$1,133.00
|
|
|
Service Code
|
CPT L5679
|
| Hospital Charge Code |
915340557
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$271.92 |
| Max. Negotiated Rate |
$963.05 |
| Rate for Payer: Adventist Health Commercial |
$464.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$963.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$623.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$849.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$685.80
|
| Rate for Payer: Blue Shield of California Commercial |
$871.28
|
| Rate for Payer: Blue Shield of California Commercial |
$574.43
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cigna of CA HMO |
$793.10
|
| Rate for Payer: Cigna of CA PPO |
$793.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$963.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$963.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$963.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$703.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$795.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$668.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$271.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$793.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$793.10
|
| Rate for Payer: Multiplan Commercial |
$906.40
|
| Rate for Payer: Networks By Design Commercial |
$566.50
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$679.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$679.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.21
|
| Rate for Payer: United Healthcare All Other HMO |
$413.88
|
| Rate for Payer: United Healthcare HMO Rider |
$404.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$371.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$963.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$963.05
|
| Rate for Payer: Vantage Medical Group Senior |
$963.05
|
|
|
HC SO DBL SHLDR ELASTIC PRE-FAB
|
Facility
|
OP
|
$284.00
|
|
| Hospital Charge Code |
905353652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Adventist Health Commercial |
$56.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$186.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$241.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$156.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$182.24
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cigna of CA HMO |
$181.76
|
| Rate for Payer: Cigna of CA PPO |
$210.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$241.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$241.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.60
|
| Rate for Payer: EPIC Health Plan Senior |
$113.60
|
| Rate for Payer: Galaxy Health WC |
$241.40
|
| Rate for Payer: Global Benefits Group Commercial |
$170.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$180.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$167.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$198.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$198.80
|
| Rate for Payer: Multiplan Commercial |
$227.20
|
| Rate for Payer: Networks By Design Commercial |
$184.60
|
| Rate for Payer: Prime Health Services Commercial |
$241.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$170.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$170.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$142.00
|
| Rate for Payer: United Healthcare All Other HMO |
$142.00
|
| Rate for Payer: United Healthcare HMO Rider |
$142.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$241.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.40
|
| Rate for Payer: Vantage Medical Group Senior |
$241.40
|
|
|
HC SO DBL SHLDR ELASTIC PRE-FAB
|
Facility
|
IP
|
$284.00
|
|
| Hospital Charge Code |
905353652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Adventist Health Commercial |
$56.80
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.60
|
| Rate for Payer: EPIC Health Plan Senior |
$113.60
|
| Rate for Payer: Galaxy Health WC |
$241.40
|
| Rate for Payer: Global Benefits Group Commercial |
$170.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$180.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$167.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.16
|
| Rate for Payer: Multiplan Commercial |
$227.20
|
| Rate for Payer: Networks By Design Commercial |
$184.60
|
| Rate for Payer: Prime Health Services Commercial |
$241.40
|
|
|
HC SODIUM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900910269
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$49.48 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Adventist Health Commercial |
$17.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.48
|
| Rate for Payer: Blue Shield of California Commercial |
$41.03
|
| Rate for Payer: Blue Shield of California Commercial |
$10.46
|
| Rate for Payer: Blue Shield of California Commercial |
$62.03
|
| Rate for Payer: Blue Shield of California Commercial |
$6.92
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$56.96
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Cigna of CA PPO |
$65.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$5.29
|
| Rate for Payer: EPIC Health Plan Senior |
$5.29
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.45
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.90
|
| Rate for Payer: United Healthcare All Other HMO |
$3.90
|
| Rate for Payer: United Healthcare All Other HMO |
$3.90
|
| Rate for Payer: United Healthcare HMO Rider |
$3.90
|
| Rate for Payer: United Healthcare HMO Rider |
$3.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC SODIUM
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900910269
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$75.65 |
| Rate for Payer: Adventist Health Commercial |
$17.80
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: EPIC Health Plan Senior |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.36
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC SODIUM BODY FLUID
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
900912246
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$49.96 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.96
|
| Rate for Payer: Blue Shield of California Commercial |
$11.53
|
| Rate for Payer: Blue Shield of California Commercial |
$13.94
|
| Rate for Payer: Blue Shield of California Commercial |
$17.43
|
| Rate for Payer: Blue Shield of California Commercial |
$9.22
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.02
|
| Rate for Payer: EPIC Health Plan Senior |
$5.35
|
| Rate for Payer: EPIC Health Plan Senior |
$5.35
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Multiplan Commercial |
$16.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.93
|
| Rate for Payer: United Healthcare All Other HMO |
$3.93
|
| Rate for Payer: United Healthcare All Other HMO |
$3.93
|
| Rate for Payer: United Healthcare HMO Rider |
$3.93
|
| Rate for Payer: United Healthcare HMO Rider |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4.86
|
|
|
HC SODIUM BODY FLUID
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
900912246
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC SODIUM CH
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900912186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$65.45 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.48
|
| Rate for Payer: Blue Shield of California Commercial |
$35.50
|
| Rate for Payer: Blue Shield of California Commercial |
$53.67
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$5.29
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.45
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.90
|
| Rate for Payer: United Healthcare All Other HMO |
$3.90
|
| Rate for Payer: United Healthcare HMO Rider |
$3.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC SODIUM CH
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900912186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$65.45 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC SODIUM FLUORIDE F-18 UP TO 30
|
Facility
|
IP
|
$1,869.00
|
|
|
Service Code
|
CPT A9580
|
| Hospital Charge Code |
909301573
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$373.80 |
| Max. Negotiated Rate |
$1,588.65 |
| Rate for Payer: Adventist Health Commercial |
$373.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,437.26
|
| Rate for Payer: Blue Shield of California Commercial |
$947.58
|
| Rate for Payer: Cash Price |
$841.05
|
| Rate for Payer: Cigna of CA HMO |
$1,308.30
|
| Rate for Payer: Cigna of CA PPO |
$1,308.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,308.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.60
|
| Rate for Payer: EPIC Health Plan Senior |
$747.60
|
| Rate for Payer: Galaxy Health WC |
$1,588.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,121.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,186.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,102.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.56
|
| Rate for Payer: Multiplan Commercial |
$1,495.20
|
| Rate for Payer: Networks By Design Commercial |
$934.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,588.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$701.44
|
| Rate for Payer: United Healthcare All Other HMO |
$682.75
|
| Rate for Payer: United Healthcare HMO Rider |
$667.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$612.10
|
|
|
HC SODIUM FLUORIDE F-18 UP TO 30
|
Facility
|
OP
|
$1,869.00
|
|
|
Service Code
|
CPT A9580
|
| Hospital Charge Code |
909301573
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$373.80 |
| Max. Negotiated Rate |
$1,588.65 |
| Rate for Payer: Adventist Health Commercial |
$373.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,588.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,027.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,401.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$766.45
|
| Rate for Payer: Cash Price |
$841.05
|
| Rate for Payer: Cash Price |
$841.05
|
| Rate for Payer: Cigna of CA HMO |
$1,308.30
|
| Rate for Payer: Cigna of CA PPO |
$1,308.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,588.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,588.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,588.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,308.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.60
|
| Rate for Payer: EPIC Health Plan Senior |
$747.60
|
| Rate for Payer: Galaxy Health WC |
$1,588.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,121.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,186.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,102.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,308.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,308.30
|
| Rate for Payer: Multiplan Commercial |
$1,495.20
|
| Rate for Payer: Networks By Design Commercial |
$934.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,588.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,121.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,121.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$701.44
|
| Rate for Payer: United Healthcare All Other HMO |
$682.75
|
| Rate for Payer: United Healthcare HMO Rider |
$667.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$612.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,588.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,588.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,588.65
|
|
|
HC SODIUM STOOL
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
900910418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.96
|
| Rate for Payer: Blue Shield of California Commercial |
$13.94
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California Commercial |
$9.22
|
| Rate for Payer: Blue Shield of California Commercial |
$82.52
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.02
|
| Rate for Payer: EPIC Health Plan Senior |
$5.35
|
| Rate for Payer: EPIC Health Plan Senior |
$5.35
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.93
|
| Rate for Payer: United Healthcare All Other HMO |
$3.93
|
| Rate for Payer: United Healthcare All Other HMO |
$3.93
|
| Rate for Payer: United Healthcare HMO Rider |
$3.93
|
| Rate for Payer: United Healthcare HMO Rider |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4.86
|
|
|
HC SODIUM STOOL
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
900910418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC SODIUM URINE
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
900910270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.17
|
| Rate for Payer: Blue Shield of California Commercial |
$13.83
|
| Rate for Payer: Blue Shield of California Commercial |
$46.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.91
|
| Rate for Payer: Blue Shield of California Commercial |
$69.70
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.35
|
| Rate for Payer: EPIC Health Plan Senior |
$5.57
|
| Rate for Payer: EPIC Health Plan Senior |
$5.57
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.78
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.09
|
| Rate for Payer: United Healthcare All Other HMO |
$4.09
|
| Rate for Payer: United Healthcare All Other HMO |
$4.09
|
| Rate for Payer: United Healthcare HMO Rider |
$4.09
|
| Rate for Payer: United Healthcare HMO Rider |
$4.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.57
|
| Rate for Payer: Vantage Medical Group Senior |
$5.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.06
|
|
|
HC SODIUM URINE
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
900910270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: EPIC Health Plan Senior |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC SOF 60735 MYCOP IGG 86738
|
Facility
|
OP
|
$65.04
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914877
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$136.13 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.13
|
| Rate for Payer: Blue Shield of California Commercial |
$29.98
|
| Rate for Payer: Blue Shield of California Commercial |
$45.33
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cigna of CA HMO |
$41.63
|
| Rate for Payer: Cigna of CA PPO |
$48.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.85
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$52.03
|
| Rate for Payer: Networks By Design Commercial |
$42.28
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOF 60735 MYCOP IGG 86738
|
Facility
|
IP
|
$65.04
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914877
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$55.28 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.02
|
| Rate for Payer: EPIC Health Plan Senior |
$26.02
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Multiplan Commercial |
$52.03
|
| Rate for Payer: Networks By Design Commercial |
$42.28
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
|
HC SOF 60735 MYCOP IGM 86738
|
Facility
|
OP
|
$65.04
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914878
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$136.13 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.13
|
| Rate for Payer: Blue Shield of California Commercial |
$29.98
|
| Rate for Payer: Blue Shield of California Commercial |
$45.33
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cigna of CA HMO |
$41.63
|
| Rate for Payer: Cigna of CA PPO |
$48.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.85
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$52.03
|
| Rate for Payer: Networks By Design Commercial |
$42.28
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOF 60735 MYCOP IGM 86738
|
Facility
|
IP
|
$65.04
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914878
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$55.28 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.02
|
| Rate for Payer: EPIC Health Plan Senior |
$26.02
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Multiplan Commercial |
$52.03
|
| Rate for Payer: Networks By Design Commercial |
$42.28
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
