|
HC SYPHILLIS TEST RPR INDIVIDUAL
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900912331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC SYPHILLIS TEST RPR INDIVIDUAL
|
Facility
|
OP
|
$182.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900912331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.17
|
| Rate for Payer: Blue Shield of California Commercial |
$15.75
|
| Rate for Payer: Blue Shield of California Commercial |
$114.66
|
| Rate for Payer: Blue Shield of California EPN |
$9.93
|
| Rate for Payer: Blue Shield of California EPN |
$72.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$4.70
|
| Rate for Payer: EPIC Health Plan Senior |
$4.70
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.27
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Riverside University Health System MISP |
$4.70
|
| Rate for Payer: Riverside University Health System MISP |
$4.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.27
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYPHILLIS TEST VDRL/ CSF
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910861
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC SYPHILLIS TEST VDRL/ CSF
|
Facility
|
OP
|
$182.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910861
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.17
|
| Rate for Payer: Blue Shield of California Commercial |
$19.53
|
| Rate for Payer: Blue Shield of California Commercial |
$114.66
|
| Rate for Payer: Blue Shield of California EPN |
$12.31
|
| Rate for Payer: Blue Shield of California EPN |
$72.25
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Central Health Plan Commercial |
$24.80
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$4.70
|
| Rate for Payer: EPIC Health Plan Senior |
$4.70
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.27
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Riverside University Health System MISP |
$4.70
|
| Rate for Payer: Riverside University Health System MISP |
$4.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.27
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYSTEM NASAL TUBE RTNR 12-14FR
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901698433
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 12-14FR
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901698433
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 16-18FR
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901698599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 16-18FR
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901698599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 8-10FR
|
Facility
|
OP
|
$613.18
|
|
| Hospital Charge Code |
901698432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.64 |
| Max. Negotiated Rate |
$551.86 |
| Rate for Payer: Adventist Health Commercial |
$122.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$372.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$521.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$459.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$296.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$356.69
|
| Rate for Payer: Blue Shield of California Commercial |
$388.76
|
| Rate for Payer: Blue Shield of California EPN |
$244.66
|
| Rate for Payer: Cash Price |
$275.93
|
| Rate for Payer: Central Health Plan Commercial |
$490.54
|
| Rate for Payer: Cigna of CA HMO |
$392.44
|
| Rate for Payer: Cigna of CA PPO |
$453.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$521.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$521.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$521.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.27
|
| Rate for Payer: EPIC Health Plan Senior |
$245.27
|
| Rate for Payer: Galaxy Health WC |
$521.20
|
| Rate for Payer: Global Benefits Group Commercial |
$367.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$222.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$429.23
|
| Rate for Payer: Multiplan Commercial |
$459.88
|
| Rate for Payer: Networks By Design Commercial |
$398.57
|
| Rate for Payer: Prime Health Services Commercial |
$521.20
|
| Rate for Payer: Riverside University Health System MISP |
$245.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$367.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$306.59
|
| Rate for Payer: United Healthcare All Other HMO |
$306.59
|
| Rate for Payer: United Healthcare HMO Rider |
$306.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$306.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$521.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$521.20
|
| Rate for Payer: Vantage Medical Group Senior |
$521.20
|
|
|
HC SYSTEM NASAL TUBE RTNR 8-10FR
|
Facility
|
IP
|
$613.18
|
|
| Hospital Charge Code |
901698432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.64 |
| Max. Negotiated Rate |
$551.86 |
| Rate for Payer: Adventist Health Commercial |
$122.64
|
| Rate for Payer: Cash Price |
$275.93
|
| Rate for Payer: Central Health Plan Commercial |
$490.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.27
|
| Rate for Payer: EPIC Health Plan Senior |
$245.27
|
| Rate for Payer: Galaxy Health WC |
$521.20
|
| Rate for Payer: Global Benefits Group Commercial |
$367.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.64
|
| Rate for Payer: Multiplan Commercial |
$459.88
|
| Rate for Payer: Networks By Design Commercial |
$398.57
|
| Rate for Payer: Prime Health Services Commercial |
$521.20
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING LRG 41-46CM
|
Facility
|
OP
|
$176.75
|
|
| Hospital Charge Code |
901607217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$159.07 |
| Rate for Payer: Adventist Health Commercial |
$35.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$150.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$97.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$132.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.82
|
| Rate for Payer: Blue Shield of California Commercial |
$112.06
|
| Rate for Payer: Blue Shield of California EPN |
$70.52
|
| Rate for Payer: Cash Price |
$79.54
|
| Rate for Payer: Central Health Plan Commercial |
$141.40
|
| Rate for Payer: Cigna of CA HMO |
$113.12
|
| Rate for Payer: Cigna of CA PPO |
$130.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$150.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$150.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$150.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$123.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.70
|
| Rate for Payer: EPIC Health Plan Senior |
$70.70
|
| Rate for Payer: Galaxy Health WC |
$150.24
|
| Rate for Payer: Global Benefits Group Commercial |
$106.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$112.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$104.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$123.72
|
| Rate for Payer: Multiplan Commercial |
$132.56
|
| Rate for Payer: Networks By Design Commercial |
$114.89
|
| Rate for Payer: Prime Health Services Commercial |
$150.24
|
| Rate for Payer: Riverside University Health System MISP |
$70.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.38
|
| Rate for Payer: United Healthcare All Other HMO |
$88.38
|
| Rate for Payer: United Healthcare HMO Rider |
$88.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$150.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$150.24
|
| Rate for Payer: Vantage Medical Group Senior |
$150.24
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING LRG 41-46CM
|
Facility
|
IP
|
$176.75
|
|
| Hospital Charge Code |
901607217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$159.07 |
| Rate for Payer: Adventist Health Commercial |
$35.35
|
| Rate for Payer: Cash Price |
$79.54
|
| Rate for Payer: Central Health Plan Commercial |
$141.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$123.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.70
|
| Rate for Payer: EPIC Health Plan Senior |
$70.70
|
| Rate for Payer: Galaxy Health WC |
$150.24
|
| Rate for Payer: Global Benefits Group Commercial |
$106.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$112.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$104.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.35
|
| Rate for Payer: Multiplan Commercial |
$132.56
|
| Rate for Payer: Networks By Design Commercial |
$114.89
|
| Rate for Payer: Prime Health Services Commercial |
$150.24
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING MED 38-41CM
|
Facility
|
OP
|
$183.75
|
|
| Hospital Charge Code |
901607216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Adventist Health Commercial |
$36.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$111.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.89
|
| Rate for Payer: Blue Shield of California Commercial |
$116.50
|
| Rate for Payer: Blue Shield of California EPN |
$73.32
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$135.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$156.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$128.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Senior |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$116.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$108.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$128.62
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
| Rate for Payer: Riverside University Health System MISP |
$73.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$110.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.88
|
| Rate for Payer: United Healthcare All Other HMO |
$91.88
|
| Rate for Payer: United Healthcare HMO Rider |
$91.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.19
|
| Rate for Payer: Vantage Medical Group Senior |
$156.19
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING MED 38-41CM
|
Facility
|
IP
|
$183.75
|
|
| Hospital Charge Code |
901607216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Adventist Health Commercial |
$36.75
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$128.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Senior |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$116.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$108.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING SM 33-38CM
|
Facility
|
OP
|
$183.75
|
|
| Hospital Charge Code |
901607215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Adventist Health Commercial |
$36.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$111.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.89
|
| Rate for Payer: Blue Shield of California Commercial |
$116.50
|
| Rate for Payer: Blue Shield of California EPN |
$73.32
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$135.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$156.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$128.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Senior |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$116.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$108.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$128.62
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
| Rate for Payer: Riverside University Health System MISP |
$73.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$110.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.88
|
| Rate for Payer: United Healthcare All Other HMO |
$91.88
|
| Rate for Payer: United Healthcare HMO Rider |
$91.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.19
|
| Rate for Payer: Vantage Medical Group Senior |
$156.19
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING SM 33-38CM
|
Facility
|
IP
|
$183.75
|
|
| Hospital Charge Code |
901607215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Adventist Health Commercial |
$36.75
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$128.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Senior |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$116.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$108.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
|
|
HC TAGGED WBC WB SCAN
|
Facility
|
OP
|
$3,380.00
|
|
|
Service Code
|
CPT 78806
|
| Hospital Charge Code |
909301443
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$3,042.00 |
| Rate for Payer: Adventist Health Commercial |
$676.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,052.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,873.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,859.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,535.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,292.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,966.15
|
| Rate for Payer: Blue Shield of California Commercial |
$2,129.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,341.86
|
| Rate for Payer: Cash Price |
$1,521.00
|
| Rate for Payer: Cash Price |
$1,521.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,704.00
|
| Rate for Payer: Cigna of CA HMO |
$2,163.20
|
| Rate for Payer: Cigna of CA PPO |
$2,501.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,873.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,873.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,873.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,366.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,352.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,352.00
|
| Rate for Payer: Galaxy Health WC |
$2,873.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,042.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,146.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,226.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,994.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$676.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,366.00
|
| Rate for Payer: Multiplan Commercial |
$2,535.00
|
| Rate for Payer: Networks By Design Commercial |
$2,197.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,352.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,028.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,028.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,690.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,690.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,873.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,873.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,873.00
|
|
|
HC TAGGED WBC WB SCAN
|
Facility
|
IP
|
$3,380.00
|
|
|
Service Code
|
CPT 78806
|
| Hospital Charge Code |
909301443
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$3,042.00 |
| Rate for Payer: Adventist Health Commercial |
$676.00
|
| Rate for Payer: Cash Price |
$1,521.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,704.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,366.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,352.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,352.00
|
| Rate for Payer: Galaxy Health WC |
$2,873.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,042.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,146.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,994.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$676.00
|
| Rate for Payer: Multiplan Commercial |
$2,535.00
|
| Rate for Payer: Networks By Design Commercial |
$2,197.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.00
|
|
|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$388.80 |
| Rate for Payer: Adventist Health Commercial |
$86.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Central Health Plan Commercial |
$345.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$302.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.80
|
| Rate for Payer: EPIC Health Plan Senior |
$172.80
|
| Rate for Payer: Galaxy Health WC |
$367.20
|
| Rate for Payer: Global Benefits Group Commercial |
$259.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$388.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$274.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$254.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$280.80
|
| Rate for Payer: Prime Health Services Commercial |
$367.20
|
|
|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$82.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$86.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$367.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$237.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Central Health Plan Commercial |
$345.60
|
| Rate for Payer: Cigna of CA HMO |
$276.48
|
| Rate for Payer: Cigna of CA PPO |
$319.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$367.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$367.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$367.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$302.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.80
|
| Rate for Payer: EPIC Health Plan Senior |
$172.80
|
| Rate for Payer: Galaxy Health WC |
$367.20
|
| Rate for Payer: Global Benefits Group Commercial |
$259.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$388.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$274.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$254.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$280.80
|
| Rate for Payer: Prime Health Services Commercial |
$367.20
|
| Rate for Payer: Riverside University Health System MISP |
$172.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$259.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$216.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$367.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$367.20
|
| Rate for Payer: Vantage Medical Group Senior |
$367.20
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
IP
|
$864.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Adventist Health Commercial |
$172.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.60
|
| Rate for Payer: EPIC Health Plan Senior |
$345.60
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$509.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
OP
|
$864.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$172.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: Cigna of CA HMO |
$552.96
|
| Rate for Payer: Cigna of CA PPO |
$639.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$518.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$432.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC TAP BLOCK UNILATERAL INJ
|
Facility
|
OP
|
$1,243.00
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
909081486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$683.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$932.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: Cigna of CA HMO |
$795.52
|
| Rate for Payer: Cigna of CA PPO |
$919.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,056.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,056.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$870.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$497.20
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$789.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$733.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$870.10
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
| Rate for Payer: Riverside University Health System MISP |
$497.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$745.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,056.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,056.55
|
|
|
HC TAP BLOCK UNILATERAL INJ
|
Facility
|
IP
|
$1,243.00
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
909081486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$1,118.70 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$870.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$497.20
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$789.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$733.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
|
|
HC TARSORRHAPHY
|
Facility
|
OP
|
$7,319.00
|
|
|
Service Code
|
CPT 67880
|
| Hospital Charge Code |
900501730
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$8,074.00 |
| Rate for Payer: Adventist Health Commercial |
$1,463.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,855.20
|
| Rate for Payer: Cigna of CA HMO |
$4,684.16
|
| Rate for Payer: Cigna of CA PPO |
$5,416.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,123.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$6,221.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,391.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,587.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,647.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,463.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$5,489.25
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$4,757.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,221.15
|
| Rate for Payer: Prime Health Services Medicare |
$3,241.31
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,363.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,391.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,659.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,659.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,659.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,659.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
