HC DRILL SKULL FOR IMPLANTATION
|
Facility
OP
|
$7,191.00
|
|
Service Code
|
CPT 61107
|
Hospital Charge Code |
900501647
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$594.19 |
Max. Negotiated Rate |
$7,282.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$1,809.80
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,112.35
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,955.05
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,955.05
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
Rate for Payer: BCBS Transplant Transplant |
$4,314.60
|
Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
Rate for Payer: Cash Price |
$3,235.95
|
Rate for Payer: Cash Price |
$3,235.95
|
Rate for Payer: Cigna of CA PPO |
$5,321.34
|
Rate for Payer: Dignity Health Commercial/Exchange |
$6,112.35
|
Rate for Payer: Dignity Health Media |
$6,112.35
|
Rate for Payer: Dignity Health Medi-Cal |
$6,112.35
|
Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
Rate for Payer: EPIC Health Plan Transplant |
$2,876.40
|
Rate for Payer: Galaxy Health WC |
$6,112.35
|
Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,393.25
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$594.19
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,725.84
|
Rate for Payer: Multiplan Commercial |
$5,752.80
|
Rate for Payer: Networks By Design Commercial |
$4,674.15
|
Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,314.60
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,314.60
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,112.35
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$6,112.35
|
Rate for Payer: Vantage Medical Group Senior |
$6,112.35
|
|
HC DRILL SKULL FOR IMPLANTATION
|
Facility
IP
|
$7,191.00
|
|
Service Code
|
CPT 61107
|
Hospital Charge Code |
900501647
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,725.84 |
Max. Negotiated Rate |
$120,000.00 |
Rate for Payer: Cash Price |
$3,235.95
|
Rate for Payer: Cash Price |
$3,235.95
|
Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
Rate for Payer: Galaxy Health WC |
$6,112.35
|
Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,739.77
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,725.84
|
Rate for Payer: Multiplan Commercial |
$5,752.80
|
Rate for Payer: Networks By Design Commercial |
$120,000.00
|
Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
|
HC DRSNG SLVR AQUACEL AG 3.5X8"
|
Facility
IP
|
$241.57
|
|
Hospital Charge Code |
901698804
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$57.98 |
Max. Negotiated Rate |
$205.33 |
Rate for Payer: Cash Price |
$108.71
|
Rate for Payer: EPIC Health Plan Commercial |
$96.63
|
Rate for Payer: Galaxy Health WC |
$205.33
|
Rate for Payer: Global Benefits Group Commercial |
$144.94
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.13
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$57.98
|
Rate for Payer: Multiplan Commercial |
$193.26
|
Rate for Payer: Networks By Design Commercial |
$157.02
|
Rate for Payer: Prime Health Services Commercial |
$205.33
|
|
HC DRSNG SLVR AQUACEL AG 3.5X8"
|
Facility
OP
|
$241.57
|
|
Hospital Charge Code |
901698804
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$57.98 |
Max. Negotiated Rate |
$205.33 |
Rate for Payer: Aetna of CA HMO/PPO |
$158.45
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$205.33
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$132.86
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$132.86
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.93
|
Rate for Payer: BCBS Transplant Transplant |
$144.94
|
Rate for Payer: Blue Shield of California Commercial |
$178.04
|
Rate for Payer: Blue Shield of California EPN |
$141.08
|
Rate for Payer: Cash Price |
$108.71
|
Rate for Payer: Cigna of CA HMO |
$154.60
|
Rate for Payer: Cigna of CA PPO |
$178.76
|
Rate for Payer: Dignity Health Commercial/Exchange |
$205.33
|
Rate for Payer: Dignity Health Media |
$205.33
|
Rate for Payer: Dignity Health Medi-Cal |
$205.33
|
Rate for Payer: EPIC Health Plan Commercial |
$96.63
|
Rate for Payer: EPIC Health Plan Transplant |
$96.63
|
Rate for Payer: Galaxy Health WC |
$205.33
|
Rate for Payer: Global Benefits Group Commercial |
$144.94
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$181.18
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.13
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$57.98
|
Rate for Payer: Multiplan Commercial |
$193.26
|
Rate for Payer: Networks By Design Commercial |
$157.02
|
Rate for Payer: Prime Health Services Commercial |
$205.33
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$144.94
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.94
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.94
|
Rate for Payer: United Healthcare All Other Commercial |
$120.78
|
Rate for Payer: United Healthcare All Other HMO |
$120.78
|
Rate for Payer: United Healthcare HMO Rider |
$120.78
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$120.78
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.33
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$205.33
|
Rate for Payer: Vantage Medical Group Senior |
$205.33
|
|
HC DRUGS ABUSE SCREEN,URINE(7)COC
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900912159
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN AMPHETAMINES
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900911077
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN BARBITUATES
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900910325
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN BENZODIAZPINES
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900911101
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN CANNABINOIDS
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900911238
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN COCAINE
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900910390
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN OPIATES
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900911145
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN PHENCYCLIDINE
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900911147
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUG SCREEN, PRE-EMPLOYMENT
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900912158
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUGS OF ABUSE SCREEN,URINE(5)
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900912160
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRUGS OF ABUSE SCREEN,URINE(7)
|
Facility
OP
|
$105.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
900912161
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$25.20 |
Max. Negotiated Rate |
$562.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.35
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
Rate for Payer: BCBS Transplant Transplant |
$63.00
|
Rate for Payer: Blue Shield of California Commercial |
$67.83
|
Rate for Payer: Blue Shield of California EPN |
$53.76
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cash Price |
$47.25
|
Rate for Payer: Cigna of CA HMO |
$67.20
|
Rate for Payer: Cigna of CA PPO |
$77.70
|
Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
Rate for Payer: Dignity Health Media |
$62.14
|
Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
Rate for Payer: Galaxy Health WC |
$89.25
|
Rate for Payer: Global Benefits Group Commercial |
$63.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
Rate for Payer: IEHP Medi-Cal |
$100.67
|
Rate for Payer: IEHP Medi-Cal Transplant |
$100.67
|
Rate for Payer: IEHP Medicare Advantage |
$62.14
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
Rate for Payer: Multiplan Commercial |
$84.00
|
Rate for Payer: Networks By Design Commercial |
$68.25
|
Rate for Payer: Prime Health Services Commercial |
$89.25
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
Rate for Payer: United Healthcare All Other HMO |
$50.34
|
Rate for Payer: United Healthcare HMO Rider |
$50.34
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
HC DRVVT
|
Facility
OP
|
$37.00
|
|
Service Code
|
CPT 85613
|
Hospital Charge Code |
900912008
|
Hospital Revenue Code
|
305
|
Min. Negotiated Rate |
$7.76 |
Max. Negotiated Rate |
$87.28 |
Rate for Payer: Aetna of CA HMO/PPO |
$79.60
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.37
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.54
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.58
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.28
|
Rate for Payer: BCBS Transplant Transplant |
$22.20
|
Rate for Payer: Blue Shield of California Commercial |
$23.90
|
Rate for Payer: Blue Shield of California EPN |
$18.94
|
Rate for Payer: Cash Price |
$16.65
|
Rate for Payer: Cash Price |
$16.65
|
Rate for Payer: Cigna of CA HMO |
$23.68
|
Rate for Payer: Cigna of CA PPO |
$27.38
|
Rate for Payer: Dignity Health Commercial/Exchange |
$14.37
|
Rate for Payer: Dignity Health Media |
$9.58
|
Rate for Payer: Dignity Health Medi-Cal |
$10.54
|
Rate for Payer: EPIC Health Plan Commercial |
$12.93
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.58
|
Rate for Payer: EPIC Health Plan Transplant |
$9.58
|
Rate for Payer: Galaxy Health WC |
$31.45
|
Rate for Payer: Global Benefits Group Commercial |
$22.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.75
|
Rate for Payer: Heritage Provider Network Commercial |
$15.71
|
Rate for Payer: Heritage Provider Network Transplant |
$15.71
|
Rate for Payer: IEHP Medi-Cal |
$15.52
|
Rate for Payer: IEHP Medi-Cal Transplant |
$15.52
|
Rate for Payer: IEHP Medicare Advantage |
$9.58
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.06
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.58
|
Rate for Payer: LLUH Dept of Risk Management WC |
$8.88
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.07
|
Rate for Payer: Molina Healthcare of CA Medicare |
$12.84
|
Rate for Payer: Multiplan Commercial |
$29.60
|
Rate for Payer: Networks By Design Commercial |
$24.05
|
Rate for Payer: Prime Health Services Commercial |
$31.45
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
Rate for Payer: United Healthcare All Other Commercial |
$7.76
|
Rate for Payer: United Healthcare All Other HMO |
$7.76
|
Rate for Payer: United Healthcare HMO Rider |
$7.76
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.76
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.37
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$10.54
|
Rate for Payer: Vantage Medical Group Senior |
$9.58
|
|
HC DSCHG RCP EDU TRAINING EA 30MN
|
Facility
IP
|
$94.00
|
|
Service Code
|
CPT 98960
|
Hospital Charge Code |
900898960
|
Hospital Revenue Code
|
410
|
Min. Negotiated Rate |
$22.56 |
Max. Negotiated Rate |
$79.90 |
Rate for Payer: Cash Price |
$42.30
|
Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
Rate for Payer: Galaxy Health WC |
$79.90
|
Rate for Payer: Global Benefits Group Commercial |
$56.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.81
|
Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
Rate for Payer: Multiplan Commercial |
$75.20
|
Rate for Payer: Networks By Design Commercial |
$61.10
|
Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
HC DSCHG RCP EDU TRAINING EA 30MN
|
Facility
OP
|
$94.00
|
|
Service Code
|
CPT 98960
|
Hospital Charge Code |
900898960
|
Hospital Revenue Code
|
410
|
Min. Negotiated Rate |
$22.56 |
Max. Negotiated Rate |
$509.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$179.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$79.90
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$51.70
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.70
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
Rate for Payer: BCBS Transplant Transplant |
$56.40
|
Rate for Payer: Blue Shield of California Commercial |
$407.00
|
Rate for Payer: Blue Shield of California EPN |
$293.00
|
Rate for Payer: Cash Price |
$42.30
|
Rate for Payer: Cash Price |
$42.30
|
Rate for Payer: Cash Price |
$42.30
|
Rate for Payer: Cash Price |
$42.30
|
Rate for Payer: Cigna of CA HMO |
$60.16
|
Rate for Payer: Cigna of CA PPO |
$69.56
|
Rate for Payer: Dignity Health Commercial/Exchange |
$79.90
|
Rate for Payer: Dignity Health Media |
$79.90
|
Rate for Payer: Dignity Health Medi-Cal |
$79.90
|
Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
Rate for Payer: EPIC Health Plan Transplant |
$37.60
|
Rate for Payer: Galaxy Health WC |
$79.90
|
Rate for Payer: Global Benefits Group Commercial |
$56.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$70.50
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
Rate for Payer: Multiplan Commercial |
$75.20
|
Rate for Payer: Networks By Design Commercial |
$61.10
|
Rate for Payer: Prime Health Services Commercial |
$79.90
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$56.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
Rate for Payer: United Healthcare All Other HMO |
$478.00
|
Rate for Payer: United Healthcare HMO Rider |
$428.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.90
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$79.90
|
Rate for Payer: Vantage Medical Group Senior |
$79.90
|
|
HC D TEST
|
Facility
OP
|
$31.00
|
|
Service Code
|
CPT 87184
|
Hospital Charge Code |
900912427
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$6.06 |
Max. Negotiated Rate |
$62.84 |
Rate for Payer: Aetna of CA HMO/PPO |
$57.36
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.22
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.23
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.48
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.84
|
Rate for Payer: BCBS Transplant Transplant |
$18.60
|
Rate for Payer: Blue Shield of California Commercial |
$20.03
|
Rate for Payer: Blue Shield of California EPN |
$15.87
|
Rate for Payer: Cash Price |
$13.95
|
Rate for Payer: Cash Price |
$13.95
|
Rate for Payer: Cigna of CA HMO |
$19.84
|
Rate for Payer: Cigna of CA PPO |
$22.94
|
Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
Rate for Payer: Dignity Health Media |
$7.48
|
Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
Rate for Payer: EPIC Health Plan Commercial |
$10.10
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.48
|
Rate for Payer: EPIC Health Plan Transplant |
$7.48
|
Rate for Payer: Galaxy Health WC |
$26.35
|
Rate for Payer: Global Benefits Group Commercial |
$18.60
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.25
|
Rate for Payer: Heritage Provider Network Commercial |
$12.27
|
Rate for Payer: Heritage Provider Network Transplant |
$12.27
|
Rate for Payer: IEHP Medi-Cal |
$12.12
|
Rate for Payer: IEHP Medi-Cal Transplant |
$12.12
|
Rate for Payer: IEHP Medicare Advantage |
$7.48
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.04
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.48
|
Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$10.02
|
Rate for Payer: Multiplan Commercial |
$24.80
|
Rate for Payer: Networks By Design Commercial |
$20.15
|
Rate for Payer: Prime Health Services Commercial |
$26.35
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.60
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
Rate for Payer: United Healthcare All Other HMO |
$6.06
|
Rate for Payer: United Healthcare HMO Rider |
$6.06
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
Rate for Payer: Vantage Medical Group Senior |
$7.48
|
|
HC DT TOXOIDS PEDS ADMIN
|
Facility
IP
|
$38.00
|
|
Hospital Charge Code |
908603028
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$9.12 |
Max. Negotiated Rate |
$32.30 |
Rate for Payer: Cash Price |
$17.10
|
Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
Rate for Payer: Galaxy Health WC |
$32.30
|
Rate for Payer: Global Benefits Group Commercial |
$22.80
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.48
|
Rate for Payer: LLUH Dept of Risk Management WC |
$9.12
|
Rate for Payer: Multiplan Commercial |
$30.40
|
Rate for Payer: Networks By Design Commercial |
$24.70
|
Rate for Payer: Prime Health Services Commercial |
$32.30
|
|
HC DT TOXOIDS PEDS ADMIN
|
Facility
OP
|
$38.00
|
|
Hospital Charge Code |
908603028
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$9.12 |
Max. Negotiated Rate |
$32.30 |
Rate for Payer: Aetna of CA HMO/PPO |
$24.92
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.30
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.90
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.90
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.64
|
Rate for Payer: BCBS Transplant Transplant |
$22.80
|
Rate for Payer: Blue Shield of California Commercial |
$28.01
|
Rate for Payer: Blue Shield of California EPN |
$22.19
|
Rate for Payer: Cash Price |
$17.10
|
Rate for Payer: Cigna of CA HMO |
$24.32
|
Rate for Payer: Cigna of CA PPO |
$28.12
|
Rate for Payer: Dignity Health Commercial/Exchange |
$32.30
|
Rate for Payer: Dignity Health Media |
$32.30
|
Rate for Payer: Dignity Health Medi-Cal |
$32.30
|
Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
Rate for Payer: EPIC Health Plan Transplant |
$15.20
|
Rate for Payer: Galaxy Health WC |
$32.30
|
Rate for Payer: Global Benefits Group Commercial |
$22.80
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.50
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.48
|
Rate for Payer: LLUH Dept of Risk Management WC |
$9.12
|
Rate for Payer: Multiplan Commercial |
$30.40
|
Rate for Payer: Networks By Design Commercial |
$24.70
|
Rate for Payer: Prime Health Services Commercial |
$32.30
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.80
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
Rate for Payer: United Healthcare All Other Commercial |
$19.00
|
Rate for Payer: United Healthcare All Other HMO |
$19.00
|
Rate for Payer: United Healthcare HMO Rider |
$19.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$19.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.30
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$32.30
|
Rate for Payer: Vantage Medical Group Senior |
$32.30
|
|
HC DUCTOGRAM/ASPIRATION-2 OR MORE
|
Facility
IP
|
$1,134.00
|
|
Service Code
|
CPT 77054
|
Hospital Charge Code |
909001446
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$272.16 |
Max. Negotiated Rate |
$963.90 |
Rate for Payer: Cash Price |
$510.30
|
Rate for Payer: EPIC Health Plan Commercial |
$453.60
|
Rate for Payer: Galaxy Health WC |
$963.90
|
Rate for Payer: Global Benefits Group Commercial |
$680.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$756.38
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.05
|
Rate for Payer: LLUH Dept of Risk Management WC |
$272.16
|
Rate for Payer: Multiplan Commercial |
$907.20
|
Rate for Payer: Networks By Design Commercial |
$737.10
|
Rate for Payer: Prime Health Services Commercial |
$963.90
|
|
HC DUCTOGRAM/ASPIRATION-2 OR MORE
|
Facility
OP
|
$1,134.00
|
|
Service Code
|
CPT 77054
|
Hospital Charge Code |
909001446
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$121.14 |
Max. Negotiated Rate |
$963.90 |
Rate for Payer: Aetna of CA HMO/PPO |
$440.49
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$956.13
|
Rate for Payer: BCBS Transplant Transplant |
$680.40
|
Rate for Payer: Blue Shield of California Commercial |
$670.19
|
Rate for Payer: Blue Shield of California EPN |
$531.85
|
Rate for Payer: Cash Price |
$510.30
|
Rate for Payer: Cash Price |
$510.30
|
Rate for Payer: Cigna of CA HMO |
$725.76
|
Rate for Payer: Cigna of CA PPO |
$839.16
|
Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
Rate for Payer: Dignity Health Media |
$306.16
|
Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
Rate for Payer: Galaxy Health WC |
$963.90
|
Rate for Payer: Global Benefits Group Commercial |
$680.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$850.50
|
Rate for Payer: Heritage Provider Network Commercial |
$502.10
|
Rate for Payer: Heritage Provider Network Transplant |
$502.10
|
Rate for Payer: IEHP Medi-Cal |
$495.98
|
Rate for Payer: IEHP Medi-Cal Transplant |
$495.98
|
Rate for Payer: IEHP Medicare Advantage |
$306.16
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$756.38
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.14
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
Rate for Payer: LLUH Dept of Risk Management WC |
$272.16
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.76
|
Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
Rate for Payer: Multiplan Commercial |
$907.20
|
Rate for Payer: Networks By Design Commercial |
$737.10
|
Rate for Payer: Prime Health Services Commercial |
$963.90
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$680.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$680.40
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$680.40
|
Rate for Payer: United Healthcare All Other Commercial |
$605.23
|
Rate for Payer: United Healthcare All Other HMO |
$605.23
|
Rate for Payer: United Healthcare HMO Rider |
$605.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$605.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
HC DUCTOGRAM/ASPIRATION- SINGLE
|
Facility
IP
|
$1,034.00
|
|
Service Code
|
CPT 77053
|
Hospital Charge Code |
909001433
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$248.16 |
Max. Negotiated Rate |
$878.90 |
Rate for Payer: Cash Price |
$465.30
|
Rate for Payer: EPIC Health Plan Commercial |
$413.60
|
Rate for Payer: Galaxy Health WC |
$878.90
|
Rate for Payer: Global Benefits Group Commercial |
$620.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$689.68
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$393.95
|
Rate for Payer: LLUH Dept of Risk Management WC |
$248.16
|
Rate for Payer: Multiplan Commercial |
$827.20
|
Rate for Payer: Networks By Design Commercial |
$672.10
|
Rate for Payer: Prime Health Services Commercial |
$878.90
|
|
HC DUCTOGRAM/ASPIRATION- SINGLE
|
Facility
OP
|
$1,034.00
|
|
Service Code
|
CPT 77053
|
Hospital Charge Code |
909001433
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$93.71 |
Max. Negotiated Rate |
$878.90 |
Rate for Payer: Aetna of CA HMO/PPO |
$319.25
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$687.09
|
Rate for Payer: BCBS Transplant Transplant |
$620.40
|
Rate for Payer: Blue Shield of California Commercial |
$611.09
|
Rate for Payer: Blue Shield of California EPN |
$484.95
|
Rate for Payer: Cash Price |
$465.30
|
Rate for Payer: Cash Price |
$465.30
|
Rate for Payer: Cigna of CA HMO |
$661.76
|
Rate for Payer: Cigna of CA PPO |
$765.16
|
Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
Rate for Payer: Dignity Health Media |
$306.16
|
Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
Rate for Payer: Galaxy Health WC |
$878.90
|
Rate for Payer: Global Benefits Group Commercial |
$620.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$775.50
|
Rate for Payer: Heritage Provider Network Commercial |
$502.10
|
Rate for Payer: Heritage Provider Network Transplant |
$502.10
|
Rate for Payer: IEHP Medi-Cal |
$495.98
|
Rate for Payer: IEHP Medi-Cal Transplant |
$495.98
|
Rate for Payer: IEHP Medicare Advantage |
$306.16
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$689.68
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.71
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
Rate for Payer: LLUH Dept of Risk Management WC |
$248.16
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.76
|
Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
Rate for Payer: Multiplan Commercial |
$827.20
|
Rate for Payer: Networks By Design Commercial |
$672.10
|
Rate for Payer: Prime Health Services Commercial |
$878.90
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$620.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$620.40
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$620.40
|
Rate for Payer: United Healthcare All Other Commercial |
$605.23
|
Rate for Payer: United Healthcare All Other HMO |
$605.23
|
Rate for Payer: United Healthcare HMO Rider |
$605.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$605.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|