|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
901300023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$311.95 |
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
| Rate for Payer: Adventist Health Commercial |
$73.40
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
901300023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$88.08 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$150.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$240.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$311.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$201.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$275.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cigna of CA HMO |
$234.88
|
| Rate for Payer: Cigna of CA PPO |
$271.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$311.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$311.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$133.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$256.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$256.90
|
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$311.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.95
|
| Rate for Payer: Vantage Medical Group Senior |
$311.95
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900400008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$88.08 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.95
|
| Rate for Payer: Vantage Medical Group Senior |
$311.95
|
| Rate for Payer: Adventist Health Commercial |
$150.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$240.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$311.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$201.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$275.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cigna of CA HMO |
$234.88
|
| Rate for Payer: Cigna of CA PPO |
$271.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$311.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$311.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$133.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$256.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$256.90
|
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$311.95
|
|
|
HC LIMB MUSCLE TESTING MANUAL OT
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905104402
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$311.95 |
| Rate for Payer: Adventist Health Commercial |
$73.40
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
|
|
HC LIMB MUSCLE TESTING MANUAL OT
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905104402
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$88.08 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$150.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$240.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$311.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$201.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$275.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cigna of CA HMO |
$234.88
|
| Rate for Payer: Cigna of CA PPO |
$271.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$311.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$311.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$133.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$256.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$256.90
|
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$311.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.95
|
| Rate for Payer: Vantage Medical Group Senior |
$311.95
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
905352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$26.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Senior |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.54
|
| Rate for Payer: United Healthcare All Other HMO |
$48.22
|
| Rate for Payer: United Healthcare HMO Rider |
$47.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.23
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
905352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Adventist Health Commercial |
$54.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$99.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.90
|
| Rate for Payer: Blue Shield of California Commercial |
$66.92
|
| Rate for Payer: Blue Shield of California Commercial |
$101.51
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$112.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Senior |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$92.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92.40
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.54
|
| Rate for Payer: United Healthcare All Other HMO |
$48.22
|
| Rate for Payer: United Healthcare HMO Rider |
$47.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
915352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Adventist Health Commercial |
$54.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$99.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.90
|
| Rate for Payer: Blue Shield of California Commercial |
$66.92
|
| Rate for Payer: Blue Shield of California Commercial |
$101.51
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$112.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Senior |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$92.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92.40
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.54
|
| Rate for Payer: United Healthcare All Other HMO |
$48.22
|
| Rate for Payer: United Healthcare HMO Rider |
$47.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
915352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$26.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Senior |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.54
|
| Rate for Payer: United Healthcare All Other HMO |
$48.22
|
| Rate for Payer: United Healthcare HMO Rider |
$47.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.23
|
|
|
HC LIPASE
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Adventist Health Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.00
|
| Rate for Payer: EPIC Health Plan Senior |
$88.00
|
| Rate for Payer: Galaxy Health WC |
$187.00
|
| Rate for Payer: Global Benefits Group Commercial |
$132.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$139.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.80
|
| Rate for Payer: Multiplan Commercial |
$176.00
|
| Rate for Payer: Networks By Design Commercial |
$143.00
|
| Rate for Payer: Prime Health Services Commercial |
$187.00
|
|
|
HC LIPASE
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Adventist Health Commercial |
$44.00
|
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Blue Shield of California Commercial |
$27.66
|
| Rate for Payer: Blue Shield of California Commercial |
$101.42
|
| Rate for Payer: Blue Shield of California Commercial |
$41.82
|
| Rate for Payer: Blue Shield of California Commercial |
$153.34
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA HMO |
$140.80
|
| Rate for Payer: Cigna of CA PPO |
$162.80
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: Galaxy Health WC |
$187.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$132.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$139.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$176.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$143.00
|
| Rate for Payer: Prime Health Services Commercial |
$187.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE BODY FLUID
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$71.02 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Blue Shield of California Commercial |
$32.27
|
| Rate for Payer: Blue Shield of California Commercial |
$24.89
|
| Rate for Payer: Blue Shield of California Commercial |
$48.79
|
| Rate for Payer: Blue Shield of California Commercial |
$37.64
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$43.20
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE BODY FLUID
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$59.50 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
|
|
HC LIPID PANEL MC
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$37.40 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17.60
|
| Rate for Payer: Galaxy Health WC |
$37.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.56
|
| Rate for Payer: Multiplan Commercial |
$35.20
|
| Rate for Payer: Networks By Design Commercial |
$28.60
|
| Rate for Payer: Prime Health Services Commercial |
$37.40
|
|
|
HC LIPID PANEL MC
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$138.21 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$111.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$20.28
|
| Rate for Payer: Blue Shield of California Commercial |
$30.67
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cigna of CA HMO |
$28.16
|
| Rate for Payer: Cigna of CA PPO |
$32.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.09
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$37.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.94
|
| Rate for Payer: Multiplan Commercial |
$35.20
|
| Rate for Payer: Networks By Design Commercial |
$28.60
|
| Rate for Payer: Prime Health Services Commercial |
$37.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.85
|
| Rate for Payer: United Healthcare All Other HMO |
$10.85
|
| Rate for Payer: United Healthcare HMO Rider |
$10.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.39
|
|
|
HC LIQUID COILS
|
Facility
|
OP
|
$1,030.40
|
|
| Hospital Charge Code |
909081813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$875.84 |
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$772.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$623.70
|
| Rate for Payer: Blue Shield of California Commercial |
$522.41
|
| Rate for Payer: Blue Shield of California Commercial |
$792.38
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cigna of CA HMO |
$721.28
|
| Rate for Payer: Cigna of CA PPO |
$721.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$875.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$875.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$721.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.16
|
| Rate for Payer: EPIC Health Plan Senior |
$412.16
|
| Rate for Payer: Galaxy Health WC |
$875.84
|
| Rate for Payer: Global Benefits Group Commercial |
$618.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$654.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$374.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$607.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$721.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$721.28
|
| Rate for Payer: Multiplan Commercial |
$824.32
|
| Rate for Payer: Networks By Design Commercial |
$515.20
|
| Rate for Payer: Prime Health Services Commercial |
$875.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$386.71
|
| Rate for Payer: United Healthcare All Other HMO |
$376.41
|
| Rate for Payer: United Healthcare HMO Rider |
$368.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.84
|
| Rate for Payer: Vantage Medical Group Senior |
$875.84
|
|
|
HC LIQUID COILS
|
Facility
|
IP
|
$1,030.40
|
|
| Hospital Charge Code |
909081813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Galaxy Health WC |
$875.84
|
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cigna of CA HMO |
$721.28
|
| Rate for Payer: Cigna of CA PPO |
$721.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$721.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.16
|
| Rate for Payer: EPIC Health Plan Senior |
$412.16
|
| Rate for Payer: Global Benefits Group Commercial |
$618.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$654.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$607.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.30
|
| Rate for Payer: Multiplan Commercial |
$824.32
|
| Rate for Payer: Networks By Design Commercial |
$515.20
|
| Rate for Payer: Prime Health Services Commercial |
$875.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$386.71
|
| Rate for Payer: United Healthcare All Other HMO |
$376.41
|
| Rate for Payer: United Healthcare HMO Rider |
$368.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.46
|
|
|
HC LITHIUM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
900910332
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: EPIC Health Plan Senior |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$92.00
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC LITHIUM
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
900910332
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Adventist Health Commercial |
$14.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.17
|
| Rate for Payer: Blue Shield of California Commercial |
$32.73
|
| Rate for Payer: Blue Shield of California Commercial |
$53.02
|
| Rate for Payer: Blue Shield of California Commercial |
$49.49
|
| Rate for Payer: Blue Shield of California Commercial |
$80.16
|
| Rate for Payer: Cash Price |
$31.95
|
| Rate for Payer: Cash Price |
$31.95
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cigna of CA HMO |
$45.44
|
| Rate for Payer: Cigna of CA HMO |
$73.60
|
| Rate for Payer: Cigna of CA PPO |
$85.10
|
| Rate for Payer: Cigna of CA PPO |
$52.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$7.27
|
| Rate for Payer: EPIC Health Plan Senior |
$7.27
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Galaxy Health WC |
$60.35
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Global Benefits Group Commercial |
$42.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$56.80
|
| Rate for Payer: Multiplan Commercial |
$92.00
|
| Rate for Payer: Networks By Design Commercial |
$46.15
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
| Rate for Payer: Prime Health Services Commercial |
$60.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.36
|
| Rate for Payer: United Healthcare All Other HMO |
$5.36
|
| Rate for Payer: United Healthcare All Other HMO |
$5.36
|
| Rate for Payer: United Healthcare HMO Rider |
$5.36
|
| Rate for Payer: United Healthcare HMO Rider |
$5.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.36
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.61
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Vantage Medical Group Senior |
$6.61
|
| Rate for Payer: Vantage Medical Group Senior |
$6.61
|
|
|
HC LITHIUM ION BATTERY, CHARGER
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
CPT L7368
|
| Hospital Charge Code |
915357368
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$170.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cigna of CA HMO |
$595.00
|
| Rate for Payer: Cigna of CA PPO |
$595.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: EPIC Health Plan Senior |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Multiplan Commercial |
$680.00
|
| Rate for Payer: Networks By Design Commercial |
$552.50
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.38
|
|
|
HC LITHIUM ION BATTERY, CHARGER
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
CPT L7368
|
| Hospital Charge Code |
905357368
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$170.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cigna of CA HMO |
$595.00
|
| Rate for Payer: Cigna of CA PPO |
$595.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: EPIC Health Plan Senior |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Multiplan Commercial |
$680.00
|
| Rate for Payer: Networks By Design Commercial |
$552.50
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.38
|
|
|
HC LITHIUM ION BATTERY, CHARGER
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
CPT L7368
|
| Hospital Charge Code |
915357368
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$722.50 |
| Rate for Payer: Adventist Health Commercial |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$637.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.50
|
| Rate for Payer: Blue Shield of California Commercial |
$653.65
|
| Rate for Payer: Blue Shield of California Commercial |
$430.95
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cigna of CA HMO |
$595.00
|
| Rate for Payer: Cigna of CA PPO |
$595.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$722.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$722.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$722.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: EPIC Health Plan Senior |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$534.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$603.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.00
|
| Rate for Payer: Multiplan Commercial |
$680.00
|
| Rate for Payer: Networks By Design Commercial |
$425.00
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$722.50
|
| Rate for Payer: Vantage Medical Group Senior |
$722.50
|
|
|
HC LITHIUM ION BATTERY, CHARGER
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
CPT L7368
|
| Hospital Charge Code |
905357368
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$722.50 |
| Rate for Payer: Adventist Health Commercial |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$637.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.50
|
| Rate for Payer: Blue Shield of California Commercial |
$653.65
|
| Rate for Payer: Blue Shield of California Commercial |
$430.95
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cigna of CA HMO |
$595.00
|
| Rate for Payer: Cigna of CA PPO |
$595.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$722.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$722.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$722.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: EPIC Health Plan Senior |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$534.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$603.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.00
|
| Rate for Payer: Multiplan Commercial |
$680.00
|
| Rate for Payer: Networks By Design Commercial |
$425.00
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$722.50
|
| Rate for Payer: Vantage Medical Group Senior |
$722.50
|
|
|
HC LITHIUM ION BATTERY, REPLACMNT
|
Facility
|
OP
|
$613.00
|
|
|
Service Code
|
CPT L7367
|
| Hospital Charge Code |
915357367
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$147.12 |
| Max. Negotiated Rate |
$521.05 |
| Rate for Payer: Adventist Health Commercial |
$251.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$521.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$459.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$371.05
|
| Rate for Payer: Blue Shield of California Commercial |
$471.40
|
| Rate for Payer: Blue Shield of California Commercial |
$310.79
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cigna of CA HMO |
$429.10
|
| Rate for Payer: Cigna of CA PPO |
$429.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$521.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$521.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$521.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.20
|
| Rate for Payer: EPIC Health Plan Senior |
$245.20
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$411.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$465.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$429.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$429.10
|
| Rate for Payer: Multiplan Commercial |
$490.40
|
| Rate for Payer: Networks By Design Commercial |
$306.50
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$367.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.06
|
| Rate for Payer: United Healthcare All Other HMO |
$223.93
|
| Rate for Payer: United Healthcare HMO Rider |
$219.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$521.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$521.05
|
| Rate for Payer: Vantage Medical Group Senior |
$521.05
|
|
|
HC LITHIUM ION BATTERY, REPLACMNT
|
Facility
|
IP
|
$613.00
|
|
|
Service Code
|
CPT L7367
|
| Hospital Charge Code |
905357367
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cigna of CA HMO |
$429.10
|
| Rate for Payer: Cigna of CA PPO |
$429.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.20
|
| Rate for Payer: EPIC Health Plan Senior |
$245.20
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.12
|
| Rate for Payer: Multiplan Commercial |
$490.40
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.06
|
| Rate for Payer: United Healthcare All Other HMO |
$223.93
|
| Rate for Payer: United Healthcare HMO Rider |
$219.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.76
|
|
