|
HC TEGADERM CHG DRSNG 4.75X4.75"
|
Facility
|
OP
|
$56.66
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901698210
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$50.99 |
| Rate for Payer: Adventist Health Commercial |
$11.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.28
|
| Rate for Payer: Blue Shield of California Commercial |
$34.62
|
| Rate for Payer: Blue Shield of California EPN |
$22.61
|
| Rate for Payer: Cash Price |
$31.16
|
| Rate for Payer: Central Health Plan Commercial |
$45.33
|
| Rate for Payer: Cigna of CA HMO |
$36.26
|
| Rate for Payer: Cigna of CA PPO |
$41.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.66
|
| Rate for Payer: EPIC Health Plan Senior |
$22.66
|
| Rate for Payer: Galaxy Health WC |
$48.16
|
| Rate for Payer: Global Benefits Group Commercial |
$34.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.99
|
| Rate for Payer: InnovAge PACE Commercial |
$28.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.66
|
| Rate for Payer: Multiplan Commercial |
$42.49
|
| Rate for Payer: Networks By Design Commercial |
$36.83
|
| Rate for Payer: Prime Health Services Commercial |
$48.16
|
| Rate for Payer: Riverside University Health System MISP |
$22.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.33
|
| Rate for Payer: United Healthcare All Other HMO |
$28.33
|
| Rate for Payer: United Healthcare HMO Rider |
$28.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.16
|
| Rate for Payer: Vantage Medical Group Senior |
$48.16
|
|
|
HC TEGADERM CHG GEL PAD
|
Facility
|
OP
|
$46.82
|
|
| Hospital Charge Code |
901698474
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Adventist Health Commercial |
$9.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.50
|
| Rate for Payer: Blue Shield of California Commercial |
$28.61
|
| Rate for Payer: Blue Shield of California EPN |
$18.68
|
| Rate for Payer: Cash Price |
$25.75
|
| Rate for Payer: Central Health Plan Commercial |
$37.46
|
| Rate for Payer: Cigna of CA HMO |
$29.96
|
| Rate for Payer: Cigna of CA PPO |
$34.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.73
|
| Rate for Payer: EPIC Health Plan Senior |
$18.73
|
| Rate for Payer: Galaxy Health WC |
$39.80
|
| Rate for Payer: Global Benefits Group Commercial |
$28.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.14
|
| Rate for Payer: InnovAge PACE Commercial |
$23.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.77
|
| Rate for Payer: Multiplan Commercial |
$35.12
|
| Rate for Payer: Networks By Design Commercial |
$30.43
|
| Rate for Payer: Prime Health Services Commercial |
$39.80
|
| Rate for Payer: Riverside University Health System MISP |
$18.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.41
|
| Rate for Payer: United Healthcare All Other HMO |
$23.41
|
| Rate for Payer: United Healthcare HMO Rider |
$23.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.80
|
| Rate for Payer: Vantage Medical Group Senior |
$39.80
|
|
|
HC TEGADERM CHG GEL PAD
|
Facility
|
IP
|
$46.82
|
|
| Hospital Charge Code |
901698474
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Adventist Health Commercial |
$9.36
|
| Rate for Payer: Cash Price |
$25.75
|
| Rate for Payer: Central Health Plan Commercial |
$37.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.73
|
| Rate for Payer: EPIC Health Plan Senior |
$18.73
|
| Rate for Payer: Galaxy Health WC |
$39.80
|
| Rate for Payer: Global Benefits Group Commercial |
$28.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Multiplan Commercial |
$35.12
|
| Rate for Payer: Networks By Design Commercial |
$30.43
|
| Rate for Payer: Prime Health Services Commercial |
$39.80
|
|
|
HC TEG-MEYER CANNULATOR
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
909001097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC TEG-MEYER CANNULATOR
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
909001097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.16
|
| Rate for Payer: Blue Shield of California Commercial |
$50.10
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: InnovAge PACE Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC TELETHERAPY ISODOSE PLAN COMPLEX
|
Facility
|
IP
|
$3,820.00
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
909177307
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$764.00 |
| Max. Negotiated Rate |
$3,438.00 |
| Rate for Payer: Adventist Health Commercial |
$764.00
|
| Rate for Payer: Cash Price |
$2,101.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,056.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,528.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,528.00
|
| Rate for Payer: Galaxy Health WC |
$3,247.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,292.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,438.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,547.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,455.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,364.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.00
|
| Rate for Payer: Multiplan Commercial |
$2,865.00
|
| Rate for Payer: Networks By Design Commercial |
$2,483.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,247.00
|
|
|
HC TELETHERAPY ISODOSE PLAN COMPLEX
|
Facility
|
OP
|
$3,820.00
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
909177307
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$196.76 |
| Max. Negotiated Rate |
$3,438.00 |
| Rate for Payer: Adventist Health Commercial |
$764.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$465.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,319.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$969.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.76
|
| Rate for Payer: Blue Shield of California Commercial |
$2,318.74
|
| Rate for Payer: Blue Shield of California EPN |
$1,516.54
|
| Rate for Payer: Cash Price |
$2,101.00
|
| Rate for Payer: Cash Price |
$2,101.00
|
| Rate for Payer: Cash Price |
$2,101.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,056.00
|
| Rate for Payer: Cigna of CA HMO |
$2,444.80
|
| Rate for Payer: Cigna of CA PPO |
$2,826.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$697.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$511.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$465.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.93
|
| Rate for Payer: EPIC Health Plan Senior |
$465.13
|
| Rate for Payer: Galaxy Health WC |
$3,247.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,292.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,438.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$762.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$431.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$465.13
|
| Rate for Payer: InnovAge PACE Commercial |
$697.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,547.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$477.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.27
|
| Rate for Payer: Multiplan Commercial |
$2,865.00
|
| Rate for Payer: Networks By Design Commercial |
$2,483.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$465.13
|
| Rate for Payer: Prime Health Services Commercial |
$3,247.00
|
| Rate for Payer: Prime Health Services Medicare |
$493.04
|
| Rate for Payer: Riverside University Health System MISP |
$511.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,292.00
|
| 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 |
$465.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Vantage Medical Group Senior |
$465.13
|
|
|
HC TELETHERAPY ISODOSE PLANSIMPLE
|
Facility
|
OP
|
$2,087.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
909177306
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$1,878.30 |
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$465.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,267.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$529.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,266.81
|
| Rate for Payer: Blue Shield of California EPN |
$828.54
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,669.60
|
| Rate for Payer: Cigna of CA HMO |
$1,335.68
|
| Rate for Payer: Cigna of CA PPO |
$1,544.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$697.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$511.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$465.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.93
|
| Rate for Payer: EPIC Health Plan Senior |
$465.13
|
| Rate for Payer: Galaxy Health WC |
$1,773.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,252.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,878.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$762.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$221.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$465.13
|
| Rate for Payer: InnovAge PACE Commercial |
$697.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,392.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.27
|
| Rate for Payer: Multiplan Commercial |
$1,565.25
|
| Rate for Payer: Networks By Design Commercial |
$1,356.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$465.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.95
|
| Rate for Payer: Prime Health Services Medicare |
$493.04
|
| Rate for Payer: Riverside University Health System MISP |
$511.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,252.20
|
| 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 |
$465.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Vantage Medical Group Senior |
$465.13
|
|
|
HC TELETHERAPY ISODOSE PLANSIMPLE
|
Facility
|
IP
|
$2,087.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
909177306
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$417.40 |
| Max. Negotiated Rate |
$1,878.30 |
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,669.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.80
|
| Rate for Payer: EPIC Health Plan Senior |
$834.80
|
| Rate for Payer: Galaxy Health WC |
$1,773.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,252.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,878.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,392.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$795.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,291.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.40
|
| Rate for Payer: Multiplan Commercial |
$1,565.25
|
| Rate for Payer: Networks By Design Commercial |
$1,356.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.95
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
IP
|
$5,649.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,129.80 |
| Max. Negotiated Rate |
$5,084.10 |
| Rate for Payer: Adventist Health Commercial |
$1,129.80
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,519.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,259.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,259.60
|
| Rate for Payer: Galaxy Health WC |
$4,801.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,389.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,084.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,767.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,152.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,496.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.80
|
| Rate for Payer: Multiplan Commercial |
$4,236.75
|
| Rate for Payer: Networks By Design Commercial |
$3,671.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,801.65
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
IP
|
$5,649.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,129.80 |
| Max. Negotiated Rate |
$5,084.10 |
| Rate for Payer: Adventist Health Commercial |
$1,129.80
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,519.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,259.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,259.60
|
| Rate for Payer: Galaxy Health WC |
$4,801.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,389.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,084.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,767.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,152.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,496.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.80
|
| Rate for Payer: Multiplan Commercial |
$4,236.75
|
| Rate for Payer: Networks By Design Commercial |
$3,671.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,801.65
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
OP
|
$5,649.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,084.10 |
| Rate for Payer: Adventist Health Commercial |
$1,129.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,230.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,960.77
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,519.20
|
| Rate for Payer: Cigna of CA HMO |
$3,615.36
|
| Rate for Payer: Cigna of CA PPO |
$4,180.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,353.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,230.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,661.35
|
| Rate for Payer: EPIC Health Plan Senior |
$1,230.63
|
| Rate for Payer: Galaxy Health WC |
$4,801.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,389.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,084.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,018.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,230.63
|
| Rate for Payer: InnovAge PACE Commercial |
$1,845.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,767.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,230.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,649.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,649.04
|
| Rate for Payer: Multiplan Commercial |
$4,236.75
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$3,671.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,230.63
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$4,801.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,304.47
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,353.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,389.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,824.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,824.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,824.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,824.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,230.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,230.63
|
|
|
HC TEMP CLOSURE/EYELIDS BY SUTURE
|
Facility
|
OP
|
$5,649.00
|
|
|
Service Code
|
CPT 67875
|
| Hospital Charge Code |
900501425
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$2,316.09
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,230.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,960.77
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Cash Price |
$3,106.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,519.20
|
| Rate for Payer: Cigna of CA HMO |
$3,615.36
|
| Rate for Payer: Cigna of CA PPO |
$4,180.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,353.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,230.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,661.35
|
| Rate for Payer: EPIC Health Plan Senior |
$1,230.63
|
| Rate for Payer: Galaxy Health WC |
$4,801.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,389.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,084.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,018.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,230.63
|
| Rate for Payer: InnovAge PACE Commercial |
$1,845.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,767.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,230.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,649.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,649.04
|
| Rate for Payer: Multiplan Commercial |
$4,236.75
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$3,671.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,230.63
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$4,801.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,304.47
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,353.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,389.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,389.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,230.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,230.63
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$14,641.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906820054
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,928.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,712.80
|
| Rate for Payer: Cigna of CA HMO |
$9,516.65
|
| Rate for Payer: Cigna of CA PPO |
$10,834.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$12,444.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,784.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,176.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$301.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,928.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$10,980.75
|
| Rate for Payer: Networks By Design Commercial |
$9,516.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Prime Health Services Commercial |
$12,444.85
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,784.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,784.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$12,445.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,489.00 |
| Max. Negotiated Rate |
$11,200.50 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,956.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,978.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,978.00
|
| Rate for Payer: Galaxy Health WC |
$10,578.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,200.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,741.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,703.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,489.00
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
| Rate for Payer: Networks By Design Commercial |
$8,089.25
|
| Rate for Payer: Prime Health Services Commercial |
$10,578.25
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$12,445.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$333.17 |
| Max. Negotiated Rate |
$17,245.35 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,956.00
|
| Rate for Payer: Cigna of CA HMO |
$7,964.80
|
| Rate for Payer: Cigna of CA PPO |
$9,209.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$10,578.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,200.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,489.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$8,089.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$10,578.25
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,467.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,222.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,222.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,222.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,222.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
OP
|
$12,445.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,956.00
|
| Rate for Payer: Cigna of CA HMO |
$8,089.25
|
| Rate for Payer: Cigna of CA PPO |
$9,209.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$10,578.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,200.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$301.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,489.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
| Rate for Payer: Networks By Design Commercial |
$8,089.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Prime Health Services Commercial |
$10,578.25
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,467.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,467.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$14,641.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906820054
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,928.20 |
| Max. Negotiated Rate |
$13,176.90 |
| Rate for Payer: Adventist Health Commercial |
$2,928.20
|
| Rate for Payer: Cash Price |
$8,052.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,712.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,856.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,856.40
|
| Rate for Payer: Galaxy Health WC |
$12,444.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,784.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,176.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,578.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,062.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,928.20
|
| Rate for Payer: Multiplan Commercial |
$10,980.75
|
| Rate for Payer: Networks By Design Commercial |
$9,516.65
|
| Rate for Payer: Prime Health Services Commercial |
$12,444.85
|
|
|
HC TEMP INSERT LEAD PCMKR DUAL
|
Facility
|
IP
|
$12,445.00
|
|
|
Service Code
|
CPT 33211
|
| Hospital Charge Code |
906811356
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,489.00 |
| Max. Negotiated Rate |
$11,200.50 |
| Rate for Payer: Adventist Health Commercial |
$2,489.00
|
| Rate for Payer: Cash Price |
$6,844.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,956.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,978.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,978.00
|
| Rate for Payer: Galaxy Health WC |
$10,578.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,467.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,200.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,741.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,703.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,489.00
|
| Rate for Payer: Multiplan Commercial |
$9,333.75
|
| Rate for Payer: Networks By Design Commercial |
$8,089.25
|
| Rate for Payer: Prime Health Services Commercial |
$10,578.25
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$11,852.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,370.40 |
| Max. Negotiated Rate |
$10,666.80 |
| Rate for Payer: Adventist Health Commercial |
$2,370.40
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,481.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,740.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,740.80
|
| Rate for Payer: Galaxy Health WC |
$10,074.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,666.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,905.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,515.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,336.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,370.40
|
| Rate for Payer: Multiplan Commercial |
$8,889.00
|
| Rate for Payer: Networks By Design Commercial |
$7,703.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,074.20
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$11,852.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,370.40 |
| Max. Negotiated Rate |
$10,666.80 |
| Rate for Payer: Adventist Health Commercial |
$2,370.40
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,481.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,740.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,740.80
|
| Rate for Payer: Galaxy Health WC |
$10,074.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,666.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,905.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,515.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,336.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,370.40
|
| Rate for Payer: Multiplan Commercial |
$8,889.00
|
| Rate for Payer: Networks By Design Commercial |
$7,703.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,074.20
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$13,944.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906820103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$448.25 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,788.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,155.20
|
| Rate for Payer: Cigna of CA HMO |
$8,924.16
|
| Rate for Payer: Cigna of CA PPO |
$10,318.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$11,852.40
|
| Rate for Payer: Global Benefits Group Commercial |
$8,366.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,549.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,300.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,788.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$10,458.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,063.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$11,852.40
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,366.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$11,852.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$448.25 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,370.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,515.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,481.60
|
| Rate for Payer: Cigna of CA HMO |
$7,585.28
|
| Rate for Payer: Cigna of CA PPO |
$8,770.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$10,074.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,666.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,905.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,370.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$8,889.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$7,703.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$10,074.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,111.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
IP
|
$13,944.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906820103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,788.80 |
| Max. Negotiated Rate |
$12,549.60 |
| Rate for Payer: Adventist Health Commercial |
$2,788.80
|
| Rate for Payer: Cash Price |
$7,669.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,155.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,577.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,577.60
|
| Rate for Payer: Galaxy Health WC |
$11,852.40
|
| Rate for Payer: Global Benefits Group Commercial |
$8,366.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,549.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,300.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,312.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,631.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,788.80
|
| Rate for Payer: Multiplan Commercial |
$10,458.00
|
| Rate for Payer: Networks By Design Commercial |
$9,063.60
|
| Rate for Payer: Prime Health Services Commercial |
$11,852.40
|
|
|
HC TEMP INSERT LEAD PCMKR SNGL
|
Facility
|
OP
|
$11,852.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
906811309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$17,245.35 |
| Rate for Payer: Adventist Health Commercial |
$2,370.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Cash Price |
$6,518.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,481.60
|
| Rate for Payer: Cigna of CA HMO |
$7,585.28
|
| Rate for Payer: Cigna of CA PPO |
$8,770.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$10,074.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,111.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,666.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: InnovAge PACE Commercial |
$15,773.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,905.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,370.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,090.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$8,889.00
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$7,703.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$10,074.20
|
| Rate for Payer: Prime Health Services Medicare |
$11,146.39
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,567.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,111.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,926.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,926.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,926.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,926.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
