|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 1
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 1
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 2
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 2
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 3
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 3
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 4
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 4
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 5
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 5
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 6
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 6
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 7
|
Facility
|
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Senior |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 7
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.61
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 8
|
Facility
|
IP
|
$19.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$17.29 |
| Rate for Payer: Adventist Health Commercial |
$3.84
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.68
|
| Rate for Payer: Galaxy Health WC |
$16.33
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.41
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.33
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 8
|
Facility
|
OP
|
$19.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Adventist Health Commercial |
$3.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.10
|
| Rate for Payer: Blue Shield of California EPN |
$7.63
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.37
|
| Rate for Payer: Cigna of CA HMO |
$12.29
|
| Rate for Payer: Cigna of CA PPO |
$14.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.90
|
| Rate for Payer: EPIC Health Plan Senior |
$8.60
|
| Rate for Payer: Galaxy Health WC |
$16.33
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.29
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.41
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.82
|
| Rate for Payer: Prime Health Services Commercial |
$16.33
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Riverside University Health System MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SPCL TRT PROC LG SGL RAD DOSE
|
Facility
|
OP
|
$7,099.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
909100313
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$199.93 |
| Max. Negotiated Rate |
$6,389.10 |
| Rate for Payer: Adventist Health Commercial |
$1,419.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$710.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$617.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,065.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$781.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$710.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,020.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,808.78
|
| Rate for Payer: Blue Shield of California Commercial |
$4,472.37
|
| Rate for Payer: Blue Shield of California EPN |
$2,818.30
|
| Rate for Payer: Cash Price |
$3,194.55
|
| Rate for Payer: Cash Price |
$3,194.55
|
| Rate for Payer: Cash Price |
$3,194.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,679.20
|
| Rate for Payer: Cigna of CA HMO |
$4,543.36
|
| Rate for Payer: Cigna of CA PPO |
$5,253.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,065.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$781.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$710.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,969.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,172.59
|
| Rate for Payer: EPIC Health Plan Senior |
$781.73
|
| Rate for Payer: Galaxy Health WC |
$6,034.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,259.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,389.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,165.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$199.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$710.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,507.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$220.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$994.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,419.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$952.28
|
| Rate for Payer: Multiplan Commercial |
$5,324.25
|
| Rate for Payer: Networks By Design Commercial |
$4,614.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$710.66
|
| Rate for Payer: Prime Health Services Commercial |
$6,034.15
|
| Rate for Payer: Prime Health Services Medicare |
$753.30
|
| Rate for Payer: Riverside University Health System MISP |
$781.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,259.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$710.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,065.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$781.73
|
| Rate for Payer: Vantage Medical Group Senior |
$710.66
|
|
|
HC SPCL TRT PROC LG SGL RAD DOSE
|
Facility
|
IP
|
$7,099.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
909100313
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,419.80 |
| Max. Negotiated Rate |
$6,389.10 |
| Rate for Payer: Adventist Health Commercial |
$1,419.80
|
| Rate for Payer: Cash Price |
$3,194.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,679.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,969.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,839.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,839.60
|
| Rate for Payer: Galaxy Health WC |
$6,034.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,259.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,389.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,507.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,188.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,419.80
|
| Rate for Payer: Multiplan Commercial |
$5,324.25
|
| Rate for Payer: Networks By Design Commercial |
$4,614.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,034.15
|
|
|
HC SPEC DOSIMETRY-TLD MICRO
|
Facility
|
IP
|
$1,756.00
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
904810814
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$351.20 |
| Max. Negotiated Rate |
$1,580.40 |
| Rate for Payer: Adventist Health Commercial |
$351.20
|
| Rate for Payer: Cash Price |
$790.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,404.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,229.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$702.40
|
| Rate for Payer: EPIC Health Plan Senior |
$702.40
|
| Rate for Payer: Galaxy Health WC |
$1,492.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,053.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,580.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,115.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,036.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.20
|
| Rate for Payer: Multiplan Commercial |
$1,317.00
|
| Rate for Payer: Networks By Design Commercial |
$1,141.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,492.60
|
|
|
HC SPEC DOSIMETRY-TLD MICRO
|
Facility
|
OP
|
$1,756.00
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
904810814
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$91.85 |
| Max. Negotiated Rate |
$1,759.00 |
| Rate for Payer: Adventist Health Commercial |
$351.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$172.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$259.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$190.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$172.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,106.28
|
| Rate for Payer: Blue Shield of California EPN |
$697.13
|
| Rate for Payer: Cash Price |
$790.20
|
| Rate for Payer: Cash Price |
$790.20
|
| Rate for Payer: Cash Price |
$790.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,404.80
|
| Rate for Payer: Cigna of CA HMO |
$1,123.84
|
| Rate for Payer: Cigna of CA PPO |
$1,299.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$259.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$190.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$172.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,229.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.24
|
| Rate for Payer: EPIC Health Plan Senior |
$190.16
|
| Rate for Payer: Galaxy Health WC |
$1,492.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,053.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,580.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$283.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$172.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,115.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$242.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$231.65
|
| Rate for Payer: Multiplan Commercial |
$1,317.00
|
| Rate for Payer: Networks By Design Commercial |
$1,141.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$172.87
|
| Rate for Payer: Prime Health Services Commercial |
$1,492.60
|
| Rate for Payer: Prime Health Services Medicare |
$183.24
|
| Rate for Payer: Riverside University Health System MISP |
$190.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,053.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$172.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$259.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$190.16
|
| Rate for Payer: Vantage Medical Group Senior |
$172.87
|
|
|
HC SPEC GRAVITY HEMATOLOGY
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900910178
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
|
|
HC SPEC GRAVITY HEMATOLOGY
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900910178
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$24.04 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.04
|
| Rate for Payer: Blue Shield of California Commercial |
$50.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7.56
|
| Rate for Payer: Blue Shield of California EPN |
$31.76
|
| Rate for Payer: Blue Shield of California EPN |
$4.76
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Cigna of CA HMO |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$59.20
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$3.83
|
| Rate for Payer: EPIC Health Plan Senior |
$3.83
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.48
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Riverside University Health System MISP |
$3.83
|
| Rate for Payer: Riverside University Health System MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC SPECIAL EXT TO INSTEP SHOE ADD
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT L3570
|
| Hospital Charge Code |
905353570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Blue Shield of California Commercial |
$136.34
|
| Rate for Payer: Blue Shield of California EPN |
$85.68
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
|
|
HC SPECIAL EXT TO INSTEP SHOE ADD
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT L3570
|
| Hospital Charge Code |
915353570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Blue Shield of California Commercial |
$136.34
|
| Rate for Payer: Blue Shield of California EPN |
$85.68
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
|
|
HC SPECIAL EXT TO INSTEP SHOE ADD
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT L3570
|
| Hospital Charge Code |
915353570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$55.67 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.89
|
| Rate for Payer: Blue Shield of California Commercial |
$136.34
|
| Rate for Payer: Blue Shield of California EPN |
$85.68
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Riverside University Health System MISP |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
