|
HC ACUPUNCTURE/TENS
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
901500002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$105.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$95.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$88.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC ACUPUNCTURE/TENS
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
901500002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$54.45 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$61.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$82.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$112.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Cigna of CA HMO |
$96.00
|
| Rate for Payer: Cigna of CA PPO |
$111.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$127.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$105.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$95.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$88.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$105.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Riverside University Health System MISP |
$60.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$127.50
|
| Rate for Payer: Vantage Medical Group Senior |
$127.50
|
|
|
HC ACUTE ABD SERIES
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
909001701
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Adventist Health Commercial |
$112.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: EPIC Health Plan Senior |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$355.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$330.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.00
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
|
|
HC ACUTE ABD SERIES
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
909001701
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Adventist Health Commercial |
$112.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$154.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.55
|
| Rate for Payer: Blue Shield of California Commercial |
$352.80
|
| Rate for Payer: Blue Shield of California EPN |
$222.32
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: Cigna of CA HMO |
$358.40
|
| Rate for Payer: Cigna of CA PPO |
$414.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$355.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$74.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$336.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$336.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC ACUTE HEPATITIS PANEL
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
900910701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$409.02 |
| Rate for Payer: Adventist Health Commercial |
$33.60
|
| Rate for Payer: Adventist Health Commercial |
$173.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.63
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$349.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$349.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$294.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$294.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$409.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$409.02
|
| Rate for Payer: Blue Shield of California Commercial |
$546.21
|
| Rate for Payer: Blue Shield of California Commercial |
$105.84
|
| Rate for Payer: Blue Shield of California EPN |
$344.20
|
| Rate for Payer: Blue Shield of California EPN |
$66.70
|
| Rate for Payer: Cash Price |
$390.15
|
| Rate for Payer: Cash Price |
$390.15
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Central Health Plan Commercial |
$134.40
|
| Rate for Payer: Central Health Plan Commercial |
$693.60
|
| Rate for Payer: Cigna of CA HMO |
$554.88
|
| Rate for Payer: Cigna of CA HMO |
$107.52
|
| Rate for Payer: Cigna of CA PPO |
$641.58
|
| Rate for Payer: Cigna of CA PPO |
$124.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$117.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$606.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.59
|
| Rate for Payer: EPIC Health Plan Senior |
$52.39
|
| Rate for Payer: EPIC Health Plan Senior |
$52.39
|
| Rate for Payer: Galaxy Health WC |
$736.95
|
| Rate for Payer: Galaxy Health WC |
$142.80
|
| Rate for Payer: Global Benefits Group Commercial |
$520.20
|
| Rate for Payer: Global Benefits Group Commercial |
$100.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$780.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$151.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$106.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$550.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.82
|
| Rate for Payer: Multiplan Commercial |
$650.25
|
| Rate for Payer: Multiplan Commercial |
$126.00
|
| Rate for Payer: Networks By Design Commercial |
$109.20
|
| Rate for Payer: Networks By Design Commercial |
$563.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.63
|
| Rate for Payer: Prime Health Services Commercial |
$736.95
|
| Rate for Payer: Prime Health Services Commercial |
$142.80
|
| Rate for Payer: Prime Health Services Medicare |
$50.49
|
| Rate for Payer: Prime Health Services Medicare |
$50.49
|
| Rate for Payer: Riverside University Health System MISP |
$52.39
|
| Rate for Payer: Riverside University Health System MISP |
$52.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$520.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$520.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.58
|
| Rate for Payer: United Healthcare All Other HMO |
$38.58
|
| Rate for Payer: United Healthcare All Other HMO |
$38.58
|
| Rate for Payer: United Healthcare HMO Rider |
$38.58
|
| Rate for Payer: United Healthcare HMO Rider |
$38.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Vantage Medical Group Senior |
$47.63
|
| Rate for Payer: Vantage Medical Group Senior |
$47.63
|
|
|
HC ACUTE HEPATITIS PANEL
|
Facility
|
IP
|
$867.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
900910701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$173.40 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: Adventist Health Commercial |
$173.40
|
| Rate for Payer: Cash Price |
$390.15
|
| Rate for Payer: Central Health Plan Commercial |
$693.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$606.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$346.80
|
| Rate for Payer: EPIC Health Plan Senior |
$346.80
|
| Rate for Payer: Galaxy Health WC |
$736.95
|
| Rate for Payer: Global Benefits Group Commercial |
$520.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$780.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$550.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$511.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.40
|
| Rate for Payer: Multiplan Commercial |
$650.25
|
| Rate for Payer: Networks By Design Commercial |
$563.55
|
| Rate for Payer: Prime Health Services Commercial |
$736.95
|
|
|
HC ADAPTER RT ANGLE Y PORT 12" AMT BUTTON
|
Facility
|
OP
|
$66.42
|
|
| Hospital Charge Code |
901698132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$59.78 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.64
|
| Rate for Payer: Blue Shield of California Commercial |
$42.11
|
| Rate for Payer: Blue Shield of California EPN |
$26.50
|
| Rate for Payer: Cash Price |
$29.89
|
| Rate for Payer: Central Health Plan Commercial |
$53.14
|
| Rate for Payer: Cigna of CA HMO |
$42.51
|
| Rate for Payer: Cigna of CA PPO |
$49.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.57
|
| Rate for Payer: EPIC Health Plan Senior |
$26.57
|
| Rate for Payer: Galaxy Health WC |
$56.46
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46.49
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.46
|
| Rate for Payer: Riverside University Health System MISP |
$26.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.21
|
| Rate for Payer: United Healthcare All Other HMO |
$33.21
|
| Rate for Payer: United Healthcare HMO Rider |
$33.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.46
|
| Rate for Payer: Vantage Medical Group Senior |
$56.46
|
|
|
HC ADAPTER RT ANGLE Y PORT 12" AMT BUTTON
|
Facility
|
IP
|
$66.42
|
|
| Hospital Charge Code |
901698132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$59.78 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Cash Price |
$29.89
|
| Rate for Payer: Central Health Plan Commercial |
$53.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.57
|
| Rate for Payer: EPIC Health Plan Senior |
$26.57
|
| Rate for Payer: Galaxy Health WC |
$56.46
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.46
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
905601756
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$59.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Central Health Plan Commercial |
$165.60
|
| Rate for Payer: Cigna of CA HMO |
$132.48
|
| Rate for Payer: Cigna of CA PPO |
$153.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$175.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
| Rate for Payer: Riverside University Health System MISP |
$82.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
905601756
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$186.30 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Central Health Plan Commercial |
$165.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.40
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE MCAL
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$186.30 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Central Health Plan Commercial |
$165.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.40
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE MCAL
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$59.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Central Health Plan Commercial |
$165.60
|
| Rate for Payer: Cigna of CA HMO |
$132.48
|
| Rate for Payer: Cigna of CA PPO |
$153.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$175.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
| Rate for Payer: Riverside University Health System MISP |
$82.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC ADC LLUH CURR/FORMER EMP RATE
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT S5102
|
| Hospital Charge Code |
908000003
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$803.00 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$306.79
|
| 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 |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| 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 ADC LLUH CURR/FORMER EMP RATE
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT S5102
|
| Hospital Charge Code |
908000003
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| 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 ADC W ADDL SERVICE
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
CPT S5102
|
| Hospital Charge Code |
908000015
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$142.20 |
| Rate for Payer: Adventist Health Commercial |
$31.60
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Central Health Plan Commercial |
$126.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.20
|
| Rate for Payer: EPIC Health Plan Senior |
$63.20
|
| Rate for Payer: Galaxy Health WC |
$134.30
|
| Rate for Payer: Global Benefits Group Commercial |
$94.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$142.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$100.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.60
|
| Rate for Payer: Multiplan Commercial |
$118.50
|
| Rate for Payer: Networks By Design Commercial |
$102.70
|
| Rate for Payer: Prime Health Services Commercial |
$134.30
|
|
|
HC ADC W ADDL SERVICE
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
CPT S5102
|
| Hospital Charge Code |
908000015
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$803.00 |
| Rate for Payer: Adventist Health Commercial |
$31.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$306.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$134.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$86.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$118.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$76.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.91
|
| Rate for Payer: Blue Shield of California Commercial |
$100.17
|
| Rate for Payer: Blue Shield of California EPN |
$63.04
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Central Health Plan Commercial |
$126.40
|
| Rate for Payer: Cigna of CA HMO |
$101.12
|
| Rate for Payer: Cigna of CA PPO |
$116.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$134.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.20
|
| Rate for Payer: EPIC Health Plan Senior |
$63.20
|
| Rate for Payer: Galaxy Health WC |
$134.30
|
| Rate for Payer: Global Benefits Group Commercial |
$94.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$142.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$100.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$110.60
|
| Rate for Payer: Multiplan Commercial |
$118.50
|
| Rate for Payer: Networks By Design Commercial |
$102.70
|
| Rate for Payer: Prime Health Services Commercial |
$134.30
|
| Rate for Payer: Riverside University Health System MISP |
$63.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$94.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$94.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$134.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.30
|
| Rate for Payer: Vantage Medical Group Senior |
$134.30
|
|
|
HC ADD ABDOMINAL BAND/STAP
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT L2660
|
| Hospital Charge Code |
915352660
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
|
|
HC ADD ABDOMINAL BAND/STAP
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT L2660
|
| Hospital Charge Code |
905352660
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
|
|
HC ADD ABDOMINAL BAND/STAP
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT L2660
|
| Hospital Charge Code |
905352660
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$81.88 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$102.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$187.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.43
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$212.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$212.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$180.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$125.00
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: Riverside University Health System MISP |
$100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.50
|
| Rate for Payer: Vantage Medical Group Senior |
$212.50
|
|
|
HC ADD ABDOMINAL BAND/STAP
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT L2660
|
| Hospital Charge Code |
915352660
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$81.88 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$102.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$187.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.43
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$212.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$212.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$180.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$125.00
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: Riverside University Health System MISP |
$100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.50
|
| Rate for Payer: Vantage Medical Group Senior |
$212.50
|
|
|
HC ADD ENOSK KNEE SHIN SYS STNC
|
Facility
|
OP
|
$9,077.00
|
|
|
Service Code
|
CPT L5845
|
| Hospital Charge Code |
915355845
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,941.69 |
| Max. Negotiated Rate |
$8,169.30 |
| Rate for Payer: Adventist Health Commercial |
$3,721.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,992.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,807.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,280.09
|
| Rate for Payer: Blue Shield of California Commercial |
$7,279.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,574.81
|
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,261.60
|
| Rate for Payer: Cigna of CA HMO |
$6,353.90
|
| Rate for Payer: Cigna of CA PPO |
$6,353.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,715.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,715.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,353.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,630.80
|
| Rate for Payer: Galaxy Health WC |
$7,715.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,446.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,169.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,941.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,763.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,144.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,355.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,721.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,353.90
|
| Rate for Payer: Multiplan Commercial |
$6,807.75
|
| Rate for Payer: Networks By Design Commercial |
$4,538.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,715.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,630.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,446.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,446.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,406.60
|
| Rate for Payer: United Healthcare All Other HMO |
$3,315.83
|
| Rate for Payer: United Healthcare HMO Rider |
$3,244.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,972.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,715.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,715.45
|
|
|
HC ADD ENOSK KNEE SHIN SYS STNC
|
Facility
|
IP
|
$9,077.00
|
|
|
Service Code
|
CPT L5845
|
| Hospital Charge Code |
905355845
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,815.40 |
| Max. Negotiated Rate |
$8,169.30 |
| Rate for Payer: Adventist Health Commercial |
$1,815.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,279.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,574.81
|
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,261.60
|
| Rate for Payer: Cigna of CA HMO |
$6,353.90
|
| Rate for Payer: Cigna of CA PPO |
$6,353.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,353.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,630.80
|
| Rate for Payer: Galaxy Health WC |
$7,715.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,446.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,169.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,763.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,355.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.40
|
| Rate for Payer: Multiplan Commercial |
$6,807.75
|
| Rate for Payer: Networks By Design Commercial |
$5,900.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,715.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,406.60
|
| Rate for Payer: United Healthcare All Other HMO |
$3,315.83
|
| Rate for Payer: United Healthcare HMO Rider |
$3,244.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,972.72
|
|
|
HC ADD ENOSK KNEE SHIN SYS STNC
|
Facility
|
IP
|
$9,077.00
|
|
|
Service Code
|
CPT L5845
|
| Hospital Charge Code |
915355845
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,815.40 |
| Max. Negotiated Rate |
$8,169.30 |
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,261.60
|
| Rate for Payer: Cigna of CA HMO |
$6,353.90
|
| Rate for Payer: Cigna of CA PPO |
$6,353.90
|
| Rate for Payer: Adventist Health Commercial |
$1,815.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,279.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,574.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,353.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,630.80
|
| Rate for Payer: Galaxy Health WC |
$7,715.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,446.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,169.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,763.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,355.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.40
|
| Rate for Payer: Multiplan Commercial |
$6,807.75
|
| Rate for Payer: Networks By Design Commercial |
$5,900.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,715.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,406.60
|
| Rate for Payer: United Healthcare All Other HMO |
$3,315.83
|
| Rate for Payer: United Healthcare HMO Rider |
$3,244.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,972.72
|
|
|
HC ADD ENOSK KNEE SHIN SYS STNC
|
Facility
|
OP
|
$9,077.00
|
|
|
Service Code
|
CPT L5845
|
| Hospital Charge Code |
905355845
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,941.69 |
| Max. Negotiated Rate |
$8,169.30 |
| Rate for Payer: Adventist Health Commercial |
$3,721.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,992.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,807.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,280.09
|
| Rate for Payer: Blue Shield of California Commercial |
$7,279.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,574.81
|
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Cash Price |
$4,084.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,261.60
|
| Rate for Payer: Cigna of CA HMO |
$6,353.90
|
| Rate for Payer: Cigna of CA PPO |
$6,353.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,715.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,715.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,353.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,630.80
|
| Rate for Payer: Galaxy Health WC |
$7,715.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,446.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,169.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,941.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,763.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,144.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,355.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,721.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,353.90
|
| Rate for Payer: Multiplan Commercial |
$6,807.75
|
| Rate for Payer: Networks By Design Commercial |
$4,538.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,715.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,630.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,446.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,446.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,406.60
|
| Rate for Payer: United Healthcare All Other HMO |
$3,315.83
|
| Rate for Payer: United Healthcare HMO Rider |
$3,244.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,972.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,715.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,715.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,715.45
|
|
|
HC ADDITIONAL FROZEN SECTIONS
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$84.36 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Adventist Health Commercial |
$76.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$323.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$209.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$285.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.36
|
| Rate for Payer: Blue Shield of California Commercial |
$239.40
|
| Rate for Payer: Blue Shield of California Commercial |
$56.70
|
| Rate for Payer: Blue Shield of California EPN |
$150.86
|
| Rate for Payer: Blue Shield of California EPN |
$35.73
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Central Health Plan Commercial |
$304.00
|
| Rate for Payer: Cigna of CA HMO |
$243.20
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$281.20
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$323.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$76.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$323.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$76.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$266.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.00
|
| Rate for Payer: EPIC Health Plan Senior |
$36.00
|
| Rate for Payer: EPIC Health Plan Senior |
$152.00
|
| Rate for Payer: Galaxy Health WC |
$323.00
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Global Benefits Group Commercial |
$228.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$342.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$241.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$266.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Multiplan Commercial |
$285.00
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$247.00
|
| Rate for Payer: Prime Health Services Commercial |
$323.00
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Riverside University Health System MISP |
$36.00
|
| Rate for Payer: Riverside University Health System MISP |
$152.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$228.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$228.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$323.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$323.00
|
| Rate for Payer: Vantage Medical Group Senior |
$323.00
|
| Rate for Payer: Vantage Medical Group Senior |
$76.50
|
|
