|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$214.20 |
| Max. Negotiated Rate |
$910.35 |
| Rate for Payer: Adventist Health Commercial |
$214.20
|
| Rate for Payer: Cash Price |
$481.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$749.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$428.40
|
| Rate for Payer: EPIC Health Plan Senior |
$428.40
|
| Rate for Payer: Galaxy Health WC |
$910.35
|
| Rate for Payer: Global Benefits Group Commercial |
$642.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$680.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$631.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.04
|
| Rate for Payer: Multiplan Commercial |
$856.80
|
| Rate for Payer: Networks By Design Commercial |
$696.15
|
| Rate for Payer: Prime Health Services Commercial |
$910.35
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
IP
|
$5,173.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,034.60 |
| Max. Negotiated Rate |
$4,397.05 |
| Rate for Payer: Adventist Health Commercial |
$1,034.60
|
| Rate for Payer: Cash Price |
$2,327.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,621.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,069.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,069.20
|
| Rate for Payer: Galaxy Health WC |
$4,397.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,103.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,284.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,052.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,241.52
|
| Rate for Payer: Multiplan Commercial |
$4,138.40
|
| Rate for Payer: Networks By Design Commercial |
$3,362.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,397.05
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
OP
|
$5,173.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,034.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18,163.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,512.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$2,327.85
|
| Rate for Payer: Cash Price |
$2,327.85
|
| Rate for Payer: Cash Price |
$2,327.85
|
| Rate for Payer: Cigna of CA HMO |
$3,310.72
|
| Rate for Payer: Cigna of CA PPO |
$3,828.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,163.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,512.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,621.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,245.94
|
| Rate for Payer: EPIC Health Plan Senior |
$18,163.96
|
| Rate for Payer: Galaxy Health WC |
$4,397.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,103.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27,080.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,512.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,284.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,877.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,117.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,241.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,805.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,127.00
|
| Rate for Payer: Multiplan Commercial |
$4,138.40
|
| Rate for Payer: Networks By Design Commercial |
$3,362.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,397.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,103.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,586.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$16,512.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,163.96
|
| Rate for Payer: Vantage Medical Group Senior |
$16,512.69
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$10,248.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,049.60 |
| Max. Negotiated Rate |
$8,710.80 |
| Rate for Payer: Adventist Health Commercial |
$2,049.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,099.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,099.20
|
| Rate for Payer: Galaxy Health WC |
$8,710.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,148.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,507.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,046.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,459.52
|
| Rate for Payer: Multiplan Commercial |
$8,198.40
|
| Rate for Payer: Networks By Design Commercial |
$6,661.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,710.80
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$10,248.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,049.60 |
| Max. Negotiated Rate |
$8,710.80 |
| Rate for Payer: Adventist Health Commercial |
$2,049.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,099.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,099.20
|
| Rate for Payer: Galaxy Health WC |
$8,710.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,148.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,507.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,046.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,459.52
|
| Rate for Payer: Multiplan Commercial |
$8,198.40
|
| Rate for Payer: Networks By Design Commercial |
$6,661.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,710.80
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$10,248.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,710.80 |
| Rate for Payer: Adventist Health Commercial |
$2,049.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cigna of CA HMO |
$6,558.72
|
| Rate for Payer: Cigna of CA PPO |
$7,583.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$8,710.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,507.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,459.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$8,198.40
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$6,661.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,710.80
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,148.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,124.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,124.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,124.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,124.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$10,248.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,710.80 |
| Rate for Payer: Adventist Health Commercial |
$4,201.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,588.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cash Price |
$4,611.60
|
| Rate for Payer: Cigna of CA HMO |
$6,558.72
|
| Rate for Payer: Cigna of CA PPO |
$7,583.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$8,710.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,507.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,459.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$8,198.40
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$6,661.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,710.80
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,148.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,148.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
IP
|
$3,465.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$693.00 |
| Max. Negotiated Rate |
$2,945.25 |
| Rate for Payer: Adventist Health Commercial |
$693.00
|
| Rate for Payer: Cash Price |
$1,559.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,425.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,386.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,386.00
|
| Rate for Payer: Galaxy Health WC |
$2,945.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,079.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,200.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,044.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.60
|
| Rate for Payer: Multiplan Commercial |
$2,772.00
|
| Rate for Payer: Networks By Design Commercial |
$2,252.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,945.25
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
OP
|
$3,465.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$128.74 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$693.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,559.25
|
| Rate for Payer: Cash Price |
$1,559.25
|
| Rate for Payer: Cash Price |
$1,559.25
|
| Rate for Payer: Cigna of CA HMO |
$2,217.60
|
| Rate for Payer: Cigna of CA PPO |
$2,564.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,425.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$2,945.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,079.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,200.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,514.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$2,772.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$2,252.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,945.25
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,079.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,732.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,732.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,732.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,732.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,049.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$581.00 |
| Max. Negotiated Rate |
$6,164.32 |
| Rate for Payer: Adventist Health Commercial |
$1,009.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,176.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cigna of CA HMO |
$3,231.36
|
| Rate for Payer: Cigna of CA PPO |
$3,736.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,534.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$4,291.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,029.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,206.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,832.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,211.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$4,039.20
|
| Rate for Payer: Networks By Design Commercial |
$3,281.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,291.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,029.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,029.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,049.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$6,164.32 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Adventist Health Commercial |
$1,009.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Cigna of CA HMO |
$3,231.36
|
| Rate for Payer: Cigna of CA PPO |
$3,736.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,534.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$4,291.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,029.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,206.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,832.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,211.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$4,039.20
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$3,281.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,291.65
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,029.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,524.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,524.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,524.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,524.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,049.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,009.80 |
| Max. Negotiated Rate |
$4,291.65 |
| Rate for Payer: Adventist Health Commercial |
$1,009.80
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,534.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,019.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,019.60
|
| Rate for Payer: Galaxy Health WC |
$4,291.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,029.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,206.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,978.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,211.76
|
| Rate for Payer: Multiplan Commercial |
$4,039.20
|
| Rate for Payer: Networks By Design Commercial |
$3,281.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,291.65
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,049.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,009.80 |
| Max. Negotiated Rate |
$4,291.65 |
| Rate for Payer: Adventist Health Commercial |
$1,009.80
|
| Rate for Payer: Cash Price |
$2,272.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,534.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,019.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,019.60
|
| Rate for Payer: Galaxy Health WC |
$4,291.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,029.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,206.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,978.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,211.76
|
| Rate for Payer: Multiplan Commercial |
$4,039.20
|
| Rate for Payer: Networks By Design Commercial |
$3,281.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,291.65
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$771.26 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$526.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$771.26
|
| Rate for Payer: Blue Shield of California Commercial |
$304.26
|
| Rate for Payer: Blue Shield of California Commercial |
$460.02
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cigna of CA HMO |
$422.40
|
| Rate for Payer: Cigna of CA PPO |
$488.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$176.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$580.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$389.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$90.37 |
| Max. Negotiated Rate |
$453.90 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$452.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.40
|
| Rate for Payer: Blue Shield of California Commercial |
$246.17
|
| Rate for Payer: Blue Shield of California Commercial |
$372.20
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Cigna of CA HMO |
$341.76
|
| Rate for Payer: Cigna of CA PPO |
$395.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$373.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$339.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$427.20
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$320.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$320.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$453.90 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$373.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.60
|
| Rate for Payer: EPIC Health Plan Senior |
$213.60
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$339.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.16
|
| Rate for Payer: Multiplan Commercial |
$427.20
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,424.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$484.80 |
| Max. Negotiated Rate |
$2,060.40 |
| Rate for Payer: Adventist Health Commercial |
$484.80
|
| Rate for Payer: Cash Price |
$1,090.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$969.60
|
| Rate for Payer: EPIC Health Plan Senior |
$969.60
|
| Rate for Payer: Galaxy Health WC |
$2,060.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,454.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,539.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,430.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$581.76
|
| Rate for Payer: Multiplan Commercial |
$1,939.20
|
| Rate for Payer: Networks By Design Commercial |
$1,575.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,060.40
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,424.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$80.44 |
| Max. Negotiated Rate |
$2,060.40 |
| Rate for Payer: Adventist Health Commercial |
$484.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,060.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,333.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,818.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,020.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,546.51
|
| Rate for Payer: Cash Price |
$1,090.80
|
| Rate for Payer: Cash Price |
$1,090.80
|
| Rate for Payer: Cigna of CA HMO |
$1,551.36
|
| Rate for Payer: Cigna of CA PPO |
$1,793.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,060.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,060.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,060.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$969.60
|
| Rate for Payer: EPIC Health Plan Senior |
$969.60
|
| Rate for Payer: Galaxy Health WC |
$2,060.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,454.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,539.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$879.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,430.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$581.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,696.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,696.80
|
| Rate for Payer: Multiplan Commercial |
$1,939.20
|
| Rate for Payer: Networks By Design Commercial |
$1,575.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,060.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,454.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,454.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,212.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,212.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,212.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,212.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,060.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,060.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,060.40
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
IP
|
$5,796.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,159.20 |
| Max. Negotiated Rate |
$4,926.60 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,318.40
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,419.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
OP
|
$5,796.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$183.25 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| 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 |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| 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 |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cigna of CA HMO |
$3,709.44
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Cigna of CA PPO |
$4,289.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$4,294.40
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,477.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$5,796.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,159.20 |
| Max. Negotiated Rate |
$4,926.60 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,318.40
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,419.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| 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: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cigna of CA HMO |
$3,709.44
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Cigna of CA PPO |
$4,289.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Multiplan Commercial |
$4,294.40
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,477.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,684.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,684.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,898.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,684.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,898.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$5,796.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,159.20 |
| Max. Negotiated Rate |
$4,926.60 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,318.40
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,419.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$5,796.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$141.36 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| 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 |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| 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 |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cigna of CA HMO |
$3,709.44
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Cigna of CA PPO |
$4,289.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$4,294.40
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,477.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
