|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$567.90 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$372.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.50
|
| Rate for Payer: United Healthcare All Other HMO |
$315.50
|
| Rate for Payer: United Healthcare HMO Rider |
$315.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$315.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$258.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$224.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.60
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$567.90 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$372.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,009.40 |
| Max. Negotiated Rate |
$4,542.30 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,532.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,018.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,018.80
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,977.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,069.27
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$448.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Cigna of CA HMO |
$3,230.08
|
| Rate for Payer: Cigna of CA PPO |
$3,734.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,532.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,028.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,028.20
|
| 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 |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Cigna of CA HMO |
$3,230.08
|
| Rate for Payer: Cigna of CA PPO |
$3,734.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,532.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,028.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,523.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,523.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,523.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,523.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,009.40 |
| Max. Negotiated Rate |
$4,542.30 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Cash Price |
$2,271.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,532.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,018.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,018.80
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,977.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
|
|
HC ANOSCOPY REMOVE LESION
|
Facility
|
IP
|
$4,163.00
|
|
|
Service Code
|
CPT 46610
|
| Hospital Charge Code |
904000012
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$832.60 |
| Max. Negotiated Rate |
$3,746.70 |
| Rate for Payer: Adventist Health Commercial |
$832.60
|
| Rate for Payer: Cash Price |
$1,873.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,330.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,914.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,665.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,665.20
|
| Rate for Payer: Galaxy Health WC |
$3,538.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,746.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,643.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,456.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$832.60
|
| Rate for Payer: Multiplan Commercial |
$3,122.25
|
| Rate for Payer: Networks By Design Commercial |
$2,705.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,538.55
|
|
|
HC ANOSCOPY REMOVE LESION
|
Facility
|
OP
|
$4,163.00
|
|
|
Service Code
|
CPT 46610
|
| Hospital Charge Code |
904000012
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$156.24 |
| Max. Negotiated Rate |
$5,890.43 |
| Rate for Payer: Adventist Health Commercial |
$832.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,569.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$451.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,639.34
|
| Rate for Payer: Blue Shield of California EPN |
$1,661.04
|
| Rate for Payer: Cash Price |
$1,873.35
|
| Rate for Payer: Cash Price |
$1,873.35
|
| Rate for Payer: Cash Price |
$1,873.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,330.40
|
| Rate for Payer: Cigna of CA HMO |
$2,664.32
|
| Rate for Payer: Cigna of CA PPO |
$3,080.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,914.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$3,538.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,746.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,643.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$172.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,997.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$832.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$3,122.25
|
| Rate for Payer: Networks By Design Commercial |
$2,705.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Prime Health Services Commercial |
$3,538.55
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,497.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,497.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,081.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,081.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,081.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,081.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
OP
|
$3,853.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$205.56 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,733.85
|
| Rate for Payer: Cash Price |
$1,733.85
|
| Rate for Payer: Cash Price |
$1,733.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: Cigna of CA HMO |
$2,465.92
|
| Rate for Payer: Cigna of CA PPO |
$2,851.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,697.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$205.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,446.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$227.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,311.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,926.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
IP
|
$3,853.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$770.60 |
| Max. Negotiated Rate |
$3,467.70 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Cash Price |
$1,733.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,697.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,541.20
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,446.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,273.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$374.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$382.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$503.17
|
| Rate for Payer: Blue Shield of California Commercial |
$544.95
|
| Rate for Payer: Blue Shield of California EPN |
$343.40
|
| Rate for Payer: Cash Price |
$389.25
|
| Rate for Payer: Cash Price |
$389.25
|
| Rate for Payer: Cash Price |
$389.25
|
| Rate for Payer: Central Health Plan Commercial |
$692.00
|
| Rate for Payer: Cigna of CA HMO |
$553.60
|
| Rate for Payer: Cigna of CA PPO |
$640.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$605.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$735.25
|
| Rate for Payer: Global Benefits Group Commercial |
$519.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$778.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$221.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$549.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$244.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$648.75
|
| Rate for Payer: Networks By Design Commercial |
$562.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$735.25
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$519.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$519.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$778.50 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Cash Price |
$389.25
|
| Rate for Payer: Central Health Plan Commercial |
$692.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$605.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$346.00
|
| Rate for Payer: EPIC Health Plan Senior |
$346.00
|
| Rate for Payer: Galaxy Health WC |
$735.25
|
| Rate for Payer: Global Benefits Group Commercial |
$519.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$778.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$549.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$510.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Multiplan Commercial |
$648.75
|
| Rate for Payer: Networks By Design Commercial |
$562.25
|
| Rate for Payer: Prime Health Services Commercial |
$735.25
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Blue Shield of California Commercial |
$332.83
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.00
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Blue Shield of California Commercial |
$332.83
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.00
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$135.91 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.41
|
| Rate for Payer: Blue Shield of California Commercial |
$332.83
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Riverside University Health System MISP |
$166.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$135.91 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.41
|
| Rate for Payer: Blue Shield of California Commercial |
$332.83
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Riverside University Health System MISP |
$166.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$684.90 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.40
|
| Rate for Payer: EPIC Health Plan Senior |
$304.40
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$448.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.41 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$461.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$183.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$163.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$227.56
|
| Rate for Payer: Blue Shield of California Commercial |
$479.43
|
| Rate for Payer: Blue Shield of California EPN |
$302.12
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Cigna of CA HMO |
$487.04
|
| Rate for Payer: Cigna of CA PPO |
$563.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$461.02
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
| Rate for Payer: Prime Health Services Medicare |
$488.68
|
| Rate for Payer: Riverside University Health System MISP |
$507.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$456.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.40
|
| Rate for Payer: EPIC Health Plan Senior |
$160.40
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.22
|
| Rate for Payer: Blue Shield of California Commercial |
$252.63
|
| Rate for Payer: Blue Shield of California EPN |
$159.20
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: Cigna of CA HMO |
$256.64
|
| Rate for Payer: Cigna of CA PPO |
$296.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.12
|
| Rate for Payer: EPIC Health Plan Senior |
$10.75
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.77
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
| Rate for Payer: Prime Health Services Medicare |
$10.36
|
| Rate for Payer: Riverside University Health System MISP |
$10.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.91
|
| Rate for Payer: United Healthcare All Other HMO |
$7.91
|
| Rate for Payer: United Healthcare HMO Rider |
$7.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.75
|
| Rate for Payer: Vantage Medical Group Senior |
$9.77
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
OP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$513.90 |
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$359.73
|
| Rate for Payer: Blue Shield of California EPN |
$226.69
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Central Health Plan Commercial |
$456.80
|
| Rate for Payer: Cigna of CA HMO |
$365.44
|
| Rate for Payer: Cigna of CA PPO |
$422.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$485.35
|
| Rate for Payer: Global Benefits Group Commercial |
$342.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$513.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$362.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$428.25
|
| Rate for Payer: Networks By Design Commercial |
$371.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$485.35
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$342.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$342.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
IP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.20 |
| Max. Negotiated Rate |
$513.90 |
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Central Health Plan Commercial |
$456.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.40
|
| Rate for Payer: EPIC Health Plan Senior |
$228.40
|
| Rate for Payer: Galaxy Health WC |
$485.35
|
| Rate for Payer: Global Benefits Group Commercial |
$342.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$513.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$362.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$336.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.20
|
| Rate for Payer: Multiplan Commercial |
$428.25
|
| Rate for Payer: Networks By Design Commercial |
$371.15
|
| Rate for Payer: Prime Health Services Commercial |
$485.35
|
|
|
HC ANTIGEN TYPING PATIENT
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
900904701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$297.90 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.68
|
| Rate for Payer: Blue Shield of California Commercial |
$208.53
|
| Rate for Payer: Blue Shield of California EPN |
$131.41
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Central Health Plan Commercial |
$264.80
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4.21
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$297.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$248.25
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.83
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Prime Health Services Medicare |
$4.06
|
| Rate for Payer: Riverside University Health System MISP |
$4.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.10
|
| Rate for Payer: United Healthcare All Other HMO |
$3.10
|
| Rate for Payer: United Healthcare HMO Rider |
$3.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.21
|
| Rate for Payer: Vantage Medical Group Senior |
$3.83
|
|
