|
HC FLEX VIDEOSCOPE AMBU
|
Facility
|
IP
|
$1,696.00
|
|
| Hospital Charge Code |
900800002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.20 |
| Max. Negotiated Rate |
$1,441.60 |
| Rate for Payer: Adventist Health Commercial |
$339.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$678.40
|
| Rate for Payer: EPIC Health Plan Senior |
$678.40
|
| Rate for Payer: Galaxy Health WC |
$1,441.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,017.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,076.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,000.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.04
|
| Rate for Payer: Multiplan Commercial |
$1,356.80
|
| Rate for Payer: Networks By Design Commercial |
$1,102.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,441.60
|
|
|
HC FLEX VIDEOSCOPE AMBU LARGE
|
Facility
|
IP
|
$1,951.00
|
|
| Hospital Charge Code |
900800003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$390.20 |
| Max. Negotiated Rate |
$1,658.35 |
| Rate for Payer: Adventist Health Commercial |
$390.20
|
| Rate for Payer: Cash Price |
$877.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,365.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$780.40
|
| Rate for Payer: Galaxy Health WC |
$1,658.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,170.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,238.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,151.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.24
|
| Rate for Payer: Multiplan Commercial |
$1,560.80
|
| Rate for Payer: Networks By Design Commercial |
$1,268.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,658.35
|
|
|
HC FLEX VIDEOSCOPE AMBU LARGE
|
Facility
|
OP
|
$1,951.00
|
|
| Hospital Charge Code |
900800003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$390.20 |
| Max. Negotiated Rate |
$1,658.35 |
| Rate for Payer: Adventist Health Commercial |
$390.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,279.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,658.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,073.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,463.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,251.96
|
| Rate for Payer: Cash Price |
$877.95
|
| Rate for Payer: Cigna of CA HMO |
$1,248.64
|
| Rate for Payer: Cigna of CA PPO |
$1,443.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,658.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,658.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,365.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$780.40
|
| Rate for Payer: Galaxy Health WC |
$1,658.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,170.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,238.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$708.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,151.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,365.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,365.70
|
| Rate for Payer: Multiplan Commercial |
$1,560.80
|
| Rate for Payer: Networks By Design Commercial |
$1,268.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,658.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,170.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,170.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$975.50
|
| Rate for Payer: United Healthcare All Other HMO |
$975.50
|
| Rate for Payer: United Healthcare HMO Rider |
$975.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$975.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,658.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,658.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.35
|
|
|
HC FLEX VIDEOSCOPE AMBU SLIM
|
Facility
|
IP
|
$1,696.00
|
|
| Hospital Charge Code |
900800001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.20 |
| Max. Negotiated Rate |
$1,441.60 |
| Rate for Payer: Adventist Health Commercial |
$339.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$678.40
|
| Rate for Payer: EPIC Health Plan Senior |
$678.40
|
| Rate for Payer: Galaxy Health WC |
$1,441.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,017.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,076.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,000.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.04
|
| Rate for Payer: Multiplan Commercial |
$1,356.80
|
| Rate for Payer: Networks By Design Commercial |
$1,102.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,441.60
|
|
|
HC FLEX VIDEOSCOPE AMBU SLIM
|
Facility
|
OP
|
$1,696.00
|
|
| Hospital Charge Code |
900800001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.20 |
| Max. Negotiated Rate |
$1,441.60 |
| Rate for Payer: Adventist Health Commercial |
$339.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,112.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$932.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,272.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,088.32
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cigna of CA HMO |
$1,085.44
|
| Rate for Payer: Cigna of CA PPO |
$1,255.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,441.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,441.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$678.40
|
| Rate for Payer: EPIC Health Plan Senior |
$678.40
|
| Rate for Payer: Galaxy Health WC |
$1,441.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,017.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,076.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,000.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,187.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,187.20
|
| Rate for Payer: Multiplan Commercial |
$1,356.80
|
| Rate for Payer: Networks By Design Commercial |
$1,102.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,441.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,017.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,017.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$848.00
|
| Rate for Payer: United Healthcare All Other HMO |
$848.00
|
| Rate for Payer: United Healthcare HMO Rider |
$848.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$848.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,441.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,441.60
|
|
|
HC FLOW VOLUME STUDY
|
Facility
|
IP
|
$421.00
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
900801022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$84.20 |
| Max. Negotiated Rate |
$357.85 |
| Rate for Payer: EPIC Health Plan Commercial |
$168.40
|
| Rate for Payer: EPIC Health Plan Senior |
$168.40
|
| Rate for Payer: Galaxy Health WC |
$357.85
|
| Rate for Payer: Adventist Health Commercial |
$84.20
|
| Rate for Payer: Cash Price |
$189.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$294.70
|
| Rate for Payer: Global Benefits Group Commercial |
$252.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$267.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$248.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.04
|
| Rate for Payer: Multiplan Commercial |
$336.80
|
| Rate for Payer: Networks By Design Commercial |
$273.65
|
| Rate for Payer: Prime Health Services Commercial |
$357.85
|
|
|
HC FLOW VOLUME STUDY
|
Facility
|
OP
|
$421.00
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
900801022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$39.01 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$84.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$270.16
|
| Rate for Payer: Blue Shield of California Commercial |
$177.24
|
| Rate for Payer: Blue Shield of California Commercial |
$268.60
|
| Rate for Payer: Cash Price |
$189.45
|
| Rate for Payer: Cash Price |
$189.45
|
| Rate for Payer: Cash Price |
$189.45
|
| Rate for Payer: Cigna of CA HMO |
$269.44
|
| Rate for Payer: Cigna of CA PPO |
$311.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$294.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$357.85
|
| Rate for Payer: Global Benefits Group Commercial |
$252.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$267.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$336.80
|
| Rate for Payer: Networks By Design Commercial |
$273.65
|
| Rate for Payer: Prime Health Services Commercial |
$357.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$252.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC FLUORESCENT STAIN FUNGI
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
900912418
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Adventist Health Commercial |
$31.20
|
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.45
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California Commercial |
$108.73
|
| Rate for Payer: Blue Shield of California Commercial |
$39.73
|
| Rate for Payer: Blue Shield of California Commercial |
$71.92
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cigna of CA HMO |
$36.48
|
| Rate for Payer: Cigna of CA HMO |
$99.84
|
| Rate for Payer: Cigna of CA PPO |
$115.44
|
| Rate for Payer: Cigna of CA PPO |
$42.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$5.93
|
| Rate for Payer: EPIC Health Plan Senior |
$5.93
|
| Rate for Payer: Galaxy Health WC |
$132.60
|
| Rate for Payer: Galaxy Health WC |
$48.45
|
| Rate for Payer: Global Benefits Group Commercial |
$93.60
|
| Rate for Payer: Global Benefits Group Commercial |
$34.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$37.05
|
| Rate for Payer: Networks By Design Commercial |
$101.40
|
| Rate for Payer: Prime Health Services Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$48.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.37
|
| Rate for Payer: United Healthcare All Other HMO |
$4.37
|
| Rate for Payer: United Healthcare All Other HMO |
$4.37
|
| Rate for Payer: United Healthcare HMO Rider |
$4.37
|
| Rate for Payer: United Healthcare HMO Rider |
$4.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.37
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.39
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.93
|
| Rate for Payer: Vantage Medical Group Senior |
$5.39
|
| Rate for Payer: Vantage Medical Group Senior |
$5.39
|
|
|
HC FLUORESCENT STAIN FUNGI
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
900912418
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Adventist Health Commercial |
$31.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Senior |
$62.40
|
| Rate for Payer: Galaxy Health WC |
$132.60
|
| Rate for Payer: Global Benefits Group Commercial |
$93.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$92.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.44
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$101.40
|
| Rate for Payer: Prime Health Services Commercial |
$132.60
|
|
|
HC FLUORO GUIDANCE CNTRL VNS ACCESS DVC
|
Facility
|
IP
|
$1,139.00
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
909081673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$227.80 |
| Max. Negotiated Rate |
$968.15 |
| Rate for Payer: Adventist Health Commercial |
$227.80
|
| Rate for Payer: Cash Price |
$512.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$797.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.60
|
| Rate for Payer: EPIC Health Plan Senior |
$455.60
|
| Rate for Payer: Galaxy Health WC |
$968.15
|
| Rate for Payer: Global Benefits Group Commercial |
$683.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$723.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$672.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.36
|
| Rate for Payer: Multiplan Commercial |
$911.20
|
| Rate for Payer: Networks By Design Commercial |
$740.35
|
| Rate for Payer: Prime Health Services Commercial |
$968.15
|
|
|
HC FLUORO GUIDANCE CNTRL VNS ACCESS DVC
|
Facility
|
OP
|
$1,139.00
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
909081673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.78 |
| Max. Negotiated Rate |
$968.15 |
| Rate for Payer: Adventist Health Commercial |
$227.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$687.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$968.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$626.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$854.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$392.06
|
| Rate for Payer: Blue Shield of California Commercial |
$726.68
|
| Rate for Payer: Blue Shield of California Commercial |
$479.52
|
| Rate for Payer: Cash Price |
$512.55
|
| Rate for Payer: Cash Price |
$512.55
|
| Rate for Payer: Cigna of CA HMO |
$728.96
|
| Rate for Payer: Cigna of CA PPO |
$842.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$968.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$968.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$968.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$797.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.60
|
| Rate for Payer: EPIC Health Plan Senior |
$455.60
|
| Rate for Payer: Galaxy Health WC |
$968.15
|
| Rate for Payer: Global Benefits Group Commercial |
$683.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$106.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$723.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$120.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$672.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$797.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$797.30
|
| Rate for Payer: Multiplan Commercial |
$911.20
|
| Rate for Payer: Networks By Design Commercial |
$740.35
|
| Rate for Payer: Prime Health Services Commercial |
$968.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$683.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$683.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$569.50
|
| Rate for Payer: United Healthcare All Other HMO |
$569.50
|
| Rate for Payer: United Healthcare HMO Rider |
$569.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$569.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$968.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$968.15
|
| Rate for Payer: Vantage Medical Group Senior |
$968.15
|
|
|
HC FLUORO GUIDE NDL PLCMNT THRPY INJ
|
Facility
|
IP
|
$1,720.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
909001368
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$1,462.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Cash Price |
$774.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,204.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,092.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,014.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Multiplan Commercial |
$1,376.00
|
| Rate for Payer: Networks By Design Commercial |
$1,118.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
|
|
HC FLUORO GUIDE NDL PLCMNT THRPY INJ
|
Facility
|
OP
|
$1,720.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
909001368
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$111.74 |
| Max. Negotiated Rate |
$1,462.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$346.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$946.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,290.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$496.85
|
| Rate for Payer: Blue Shield of California Commercial |
$724.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,097.36
|
| Rate for Payer: Cash Price |
$774.00
|
| Rate for Payer: Cash Price |
$774.00
|
| Rate for Payer: Cigna of CA HMO |
$1,100.80
|
| Rate for Payer: Cigna of CA PPO |
$1,272.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,462.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,462.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,204.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$111.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,092.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$126.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,014.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,204.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,204.00
|
| Rate for Payer: Multiplan Commercial |
$1,376.00
|
| Rate for Payer: Networks By Design Commercial |
$1,118.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,032.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,032.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$860.00
|
| Rate for Payer: United Healthcare All Other HMO |
$860.00
|
| Rate for Payer: United Healthcare HMO Rider |
$860.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$860.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,462.00
|
|
|
HC FLUORO GUIDE SPINE OR PARASPINOUS
|
Facility
|
OP
|
$1,226.00
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
909001358
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.56 |
| Max. Negotiated Rate |
$1,042.10 |
| Rate for Payer: Adventist Health Commercial |
$245.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,042.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$674.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$919.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$379.55
|
| Rate for Payer: Blue Shield of California Commercial |
$782.19
|
| Rate for Payer: Blue Shield of California Commercial |
$516.15
|
| Rate for Payer: Cash Price |
$551.70
|
| Rate for Payer: Cash Price |
$551.70
|
| Rate for Payer: Cigna of CA HMO |
$784.64
|
| Rate for Payer: Cigna of CA PPO |
$907.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,042.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,042.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,042.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$858.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$490.40
|
| Rate for Payer: EPIC Health Plan Senior |
$490.40
|
| Rate for Payer: Galaxy Health WC |
$1,042.10
|
| Rate for Payer: Global Benefits Group Commercial |
$735.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$95.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$778.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$108.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$723.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$858.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$858.20
|
| Rate for Payer: Multiplan Commercial |
$980.80
|
| Rate for Payer: Networks By Design Commercial |
$796.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,042.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$735.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$735.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$613.00
|
| Rate for Payer: United Healthcare All Other HMO |
$613.00
|
| Rate for Payer: United Healthcare HMO Rider |
$613.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$613.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,042.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,042.10
|
| Rate for Payer: Vantage Medical Group Senior |
$1,042.10
|
|
|
HC FLUORO GUIDE SPINE OR PARASPINOUS
|
Facility
|
IP
|
$1,226.00
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
909001358
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$245.20 |
| Max. Negotiated Rate |
$1,042.10 |
| Rate for Payer: Adventist Health Commercial |
$245.20
|
| Rate for Payer: Cash Price |
$551.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$858.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$490.40
|
| Rate for Payer: EPIC Health Plan Senior |
$490.40
|
| Rate for Payer: Galaxy Health WC |
$1,042.10
|
| Rate for Payer: Global Benefits Group Commercial |
$735.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$778.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$723.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.24
|
| Rate for Payer: Multiplan Commercial |
$980.80
|
| Rate for Payer: Networks By Design Commercial |
$796.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,042.10
|
|
|
HC FLUORO IN RAD > 1 HR
|
Facility
|
IP
|
$1,617.00
|
|
|
Service Code
|
CPT 76001
|
| Hospital Charge Code |
909001670
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.40 |
| Max. Negotiated Rate |
$1,374.45 |
| Rate for Payer: Adventist Health Commercial |
$323.40
|
| Rate for Payer: Cash Price |
$727.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,131.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.80
|
| Rate for Payer: EPIC Health Plan Senior |
$646.80
|
| Rate for Payer: Galaxy Health WC |
$1,374.45
|
| Rate for Payer: Global Benefits Group Commercial |
$970.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,026.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$954.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.08
|
| Rate for Payer: Multiplan Commercial |
$1,293.60
|
| Rate for Payer: Networks By Design Commercial |
$1,051.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,374.45
|
|
|
HC FLUORO IN RAD > 1 HR
|
Facility
|
OP
|
$1,617.00
|
|
|
Service Code
|
CPT 76001
|
| Hospital Charge Code |
909001670
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.40 |
| Max. Negotiated Rate |
$1,374.45 |
| Rate for Payer: Adventist Health Commercial |
$323.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,060.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,374.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$889.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,212.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$774.73
|
| Rate for Payer: Blue Shield of California Commercial |
$1,031.65
|
| Rate for Payer: Blue Shield of California Commercial |
$680.76
|
| Rate for Payer: Cash Price |
$727.65
|
| Rate for Payer: Cash Price |
$727.65
|
| Rate for Payer: Cigna of CA HMO |
$1,034.88
|
| Rate for Payer: Cigna of CA PPO |
$1,196.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,374.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,374.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,374.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,131.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.80
|
| Rate for Payer: EPIC Health Plan Senior |
$646.80
|
| Rate for Payer: Galaxy Health WC |
$1,374.45
|
| Rate for Payer: Global Benefits Group Commercial |
$970.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,026.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$586.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$954.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,131.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,131.90
|
| Rate for Payer: Multiplan Commercial |
$1,293.60
|
| Rate for Payer: Networks By Design Commercial |
$1,051.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,374.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$970.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$970.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$808.50
|
| Rate for Payer: United Healthcare All Other HMO |
$808.50
|
| Rate for Payer: United Healthcare HMO Rider |
$808.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$808.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,374.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,374.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,374.45
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
OP
|
$1,349.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906811312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.97 |
| Max. Negotiated Rate |
$1,146.65 |
| Rate for Payer: Adventist Health Commercial |
$269.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.98
|
| Rate for Payer: Blue Shield of California Commercial |
$567.93
|
| Rate for Payer: Blue Shield of California Commercial |
$860.66
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Cigna of CA HMO |
$863.36
|
| Rate for Payer: Cigna of CA PPO |
$998.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$944.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$1,146.65
|
| Rate for Payer: Global Benefits Group Commercial |
$809.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$46.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$856.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,079.20
|
| Rate for Payer: Networks By Design Commercial |
$876.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,146.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$809.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$809.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
IP
|
$1,349.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906811312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.80 |
| Max. Negotiated Rate |
$1,146.65 |
| Rate for Payer: Adventist Health Commercial |
$269.80
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$944.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$539.60
|
| Rate for Payer: EPIC Health Plan Senior |
$539.60
|
| Rate for Payer: Galaxy Health WC |
$1,146.65
|
| Rate for Payer: Global Benefits Group Commercial |
$809.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$856.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$795.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.76
|
| Rate for Payer: Multiplan Commercial |
$1,079.20
|
| Rate for Payer: Networks By Design Commercial |
$876.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,146.65
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
OP
|
$3,706.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.05 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$741.20
|
| Rate for Payer: Adventist Health Commercial |
$457.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cigna of CA HMO |
$1,463.04
|
| Rate for Payer: Cigna of CA HMO |
$2,371.84
|
| Rate for Payer: Cigna of CA PPO |
$2,742.44
|
| Rate for Payer: Cigna of CA PPO |
$1,691.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,600.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,594.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$3,150.10
|
| Rate for Payer: Galaxy Health WC |
$1,943.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,371.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,353.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,451.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$548.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,828.80
|
| Rate for Payer: Multiplan Commercial |
$2,964.80
|
| Rate for Payer: Multiplan WC |
$489.35
|
| Rate for Payer: Multiplan WC |
$489.35
|
| Rate for Payer: Networks By Design Commercial |
$2,408.90
|
| Rate for Payer: Networks By Design Commercial |
$1,485.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,150.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,943.10
|
| Rate for Payer: Prime Health Services WC |
$484.36
|
| Rate for Payer: Prime Health Services WC |
$484.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,223.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,371.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,853.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,143.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
IP
|
$3,706.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$741.20 |
| Max. Negotiated Rate |
$3,150.10 |
| Rate for Payer: Adventist Health Commercial |
$741.20
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,594.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,482.40
|
| Rate for Payer: Galaxy Health WC |
$3,150.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,353.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,186.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.44
|
| Rate for Payer: Multiplan Commercial |
$2,964.80
|
| Rate for Payer: Networks By Design Commercial |
$2,408.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,150.10
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
IP
|
$3,706.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.20 |
| Max. Negotiated Rate |
$3,150.10 |
| Rate for Payer: Adventist Health Commercial |
$741.20
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,594.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,482.40
|
| Rate for Payer: Galaxy Health WC |
$3,150.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,353.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,186.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.44
|
| Rate for Payer: Multiplan Commercial |
$2,964.80
|
| Rate for Payer: Networks By Design Commercial |
$2,408.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,150.10
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
OP
|
$3,706.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$237.05 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$741.20
|
| Rate for Payer: Adventist Health Commercial |
$457.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,028.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cigna of CA HMO |
$2,371.84
|
| Rate for Payer: Cigna of CA HMO |
$1,463.04
|
| Rate for Payer: Cigna of CA PPO |
$1,691.64
|
| Rate for Payer: Cigna of CA PPO |
$2,742.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,594.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,600.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$3,150.10
|
| Rate for Payer: Galaxy Health WC |
$1,943.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,371.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,353.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,451.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$548.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,828.80
|
| Rate for Payer: Multiplan Commercial |
$2,964.80
|
| Rate for Payer: Networks By Design Commercial |
$2,408.90
|
| Rate for Payer: Networks By Design Commercial |
$1,485.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,150.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,943.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,223.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,371.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$368.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$368.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,143.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,853.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC FMRI BRAIN BY PHYS/PSYCH
|
Facility
|
OP
|
$1,636.00
|
|
|
Service Code
|
CPT 70555
|
| Hospital Charge Code |
908801023
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$166.34 |
| Max. Negotiated Rate |
$2,328.99 |
| Rate for Payer: Adventist Health Commercial |
$327.20
|
| Rate for Payer: Adventist Health Commercial |
$389.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,248.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,049.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,043.77
|
| Rate for Payer: Blue Shield of California Commercial |
$818.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,240.91
|
| Rate for Payer: Blue Shield of California Commercial |
$688.76
|
| Rate for Payer: Cash Price |
$875.25
|
| Rate for Payer: Cash Price |
$736.20
|
| Rate for Payer: Cash Price |
$875.25
|
| Rate for Payer: Cash Price |
$736.20
|
| Rate for Payer: Cigna of CA HMO |
$1,244.80
|
| Rate for Payer: Cigna of CA HMO |
$1,047.04
|
| Rate for Payer: Cigna of CA PPO |
$1,210.64
|
| Rate for Payer: Cigna of CA PPO |
$1,439.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,361.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,145.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$1,653.25
|
| Rate for Payer: Galaxy Health WC |
$1,390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$981.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,167.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$166.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$166.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,038.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,235.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,556.00
|
| Rate for Payer: Multiplan Commercial |
$1,308.80
|
| Rate for Payer: Networks By Design Commercial |
$1,063.40
|
| Rate for Payer: Networks By Design Commercial |
$1,264.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,390.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,653.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,167.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$981.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$981.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,167.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC FMRI BRAIN BY PHYS/PSYCH
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
CPT 70555
|
| Hospital Charge Code |
908801023
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$389.00 |
| Max. Negotiated Rate |
$1,653.25 |
| Rate for Payer: Adventist Health Commercial |
$389.00
|
| Rate for Payer: Cash Price |
$875.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,361.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$778.00
|
| Rate for Payer: EPIC Health Plan Senior |
$778.00
|
| Rate for Payer: Galaxy Health WC |
$1,653.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,167.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,235.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,147.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.80
|
| Rate for Payer: Multiplan Commercial |
$1,556.00
|
| Rate for Payer: Networks By Design Commercial |
$1,264.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,653.25
|
|
