|
HC ASCOPE 4RHINO SLIM 3.0MM
|
Facility
|
OP
|
$883.20
|
|
| Hospital Charge Code |
900831699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.64 |
| Max. Negotiated Rate |
$794.88 |
| Rate for Payer: Adventist Health Commercial |
$176.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$536.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$750.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$485.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$662.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$427.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.76
|
| Rate for Payer: Blue Shield of California Commercial |
$559.95
|
| Rate for Payer: Blue Shield of California EPN |
$352.40
|
| Rate for Payer: Cash Price |
$397.44
|
| Rate for Payer: Central Health Plan Commercial |
$706.56
|
| Rate for Payer: Cigna of CA HMO |
$565.25
|
| Rate for Payer: Cigna of CA PPO |
$653.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$750.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$750.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$750.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$618.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.28
|
| Rate for Payer: EPIC Health Plan Senior |
$353.28
|
| Rate for Payer: Galaxy Health WC |
$750.72
|
| Rate for Payer: Global Benefits Group Commercial |
$529.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$794.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$560.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$521.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$618.24
|
| Rate for Payer: Multiplan Commercial |
$662.40
|
| Rate for Payer: Networks By Design Commercial |
$574.08
|
| Rate for Payer: Prime Health Services Commercial |
$750.72
|
| Rate for Payer: Riverside University Health System MISP |
$353.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$529.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$529.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$441.60
|
| Rate for Payer: United Healthcare All Other HMO |
$441.60
|
| Rate for Payer: United Healthcare HMO Rider |
$441.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$750.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$750.72
|
| Rate for Payer: Vantage Medical Group Senior |
$750.72
|
|
|
HC ASCOPE 4RHINO SLIM 3.0MM
|
Facility
|
IP
|
$883.20
|
|
| Hospital Charge Code |
900831699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.64 |
| Max. Negotiated Rate |
$794.88 |
| Rate for Payer: Adventist Health Commercial |
$176.64
|
| Rate for Payer: Cash Price |
$397.44
|
| Rate for Payer: Central Health Plan Commercial |
$706.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$618.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.28
|
| Rate for Payer: EPIC Health Plan Senior |
$353.28
|
| Rate for Payer: Galaxy Health WC |
$750.72
|
| Rate for Payer: Global Benefits Group Commercial |
$529.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$794.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$560.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$521.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.64
|
| Rate for Payer: Multiplan Commercial |
$662.40
|
| Rate for Payer: Networks By Design Commercial |
$574.08
|
| Rate for Payer: Prime Health Services Commercial |
$750.72
|
|
|
HC ASPARAGUS IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ASPARAGUS IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$2,683.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$89.65 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$321.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$492.37
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Cigna of CA HMO |
$1,717.12
|
| Rate for Payer: Cigna of CA PPO |
$1,985.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$482.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$353.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$321.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.23
|
| Rate for Payer: EPIC Health Plan Senior |
$353.49
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$527.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$321.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$449.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$430.61
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$321.35
|
| Rate for Payer: Preferred Health Network WC |
$502.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
| Rate for Payer: Prime Health Services Medicare |
$340.63
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Riverside University Health System MISP |
$353.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,609.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,341.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$321.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Vantage Medical Group Senior |
$321.35
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$2,683.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.03 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| 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 |
$482.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.35
|
| 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 |
$492.37
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Cigna of CA HMO |
$1,717.12
|
| Rate for Payer: Cigna of CA PPO |
$1,985.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$482.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$353.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$321.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.23
|
| Rate for Payer: EPIC Health Plan Senior |
$353.49
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$527.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$321.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$345.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$430.61
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$321.35
|
| Rate for Payer: Preferred Health Network WC |
$502.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
| Rate for Payer: Prime Health Services Medicare |
$340.63
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Riverside University Health System MISP |
$353.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,609.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,341.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,341.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,341.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,341.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$321.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Vantage Medical Group Senior |
$321.35
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$2,683.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$536.60 |
| Max. Negotiated Rate |
$2,414.70 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,073.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,073.20
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,582.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$2,683.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$536.60 |
| Max. Negotiated Rate |
$2,414.70 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,073.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,073.20
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,582.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
OP
|
$1,489.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.90 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$907.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Cigna of CA HMO |
$952.96
|
| Rate for Payer: Cigna of CA PPO |
$1,101.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,271.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$907.88
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
| Rate for Payer: Prime Health Services Medicare |
$962.35
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$998.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$893.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$744.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
IP
|
$1,489.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.80 |
| Max. Negotiated Rate |
$1,340.10 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$595.60
|
| Rate for Payer: EPIC Health Plan Senior |
$595.60
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$878.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
IP
|
$1,489.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.80 |
| Max. Negotiated Rate |
$1,340.10 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$595.60
|
| Rate for Payer: EPIC Health Plan Senior |
$595.60
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$878.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
OP
|
$1,489.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.95 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Cigna of CA HMO |
$952.96
|
| Rate for Payer: Cigna of CA PPO |
$1,101.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$173.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$893.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$744.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
OP
|
$1,489.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.19 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Cigna of CA HMO |
$952.96
|
| Rate for Payer: Cigna of CA PPO |
$1,101.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$893.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$744.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
IP
|
$1,489.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.80 |
| Max. Negotiated Rate |
$1,340.10 |
| Rate for Payer: Adventist Health Commercial |
$297.80
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,042.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$595.60
|
| Rate for Payer: EPIC Health Plan Senior |
$595.60
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$945.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$878.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,676.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$335.20
|
| 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 |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Cigna of CA HMO |
$1,072.64
|
| Rate for Payer: Cigna of CA PPO |
$1,240.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,173.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,064.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,005.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$838.00
|
| Rate for Payer: United Healthcare All Other HMO |
$838.00
|
| Rate for Payer: United Healthcare HMO Rider |
$838.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$838.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,676.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.50 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$335.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Cigna of CA HMO |
$1,072.64
|
| Rate for Payer: Cigna of CA PPO |
$1,240.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,173.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$93.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,064.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,005.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$838.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,676.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$335.20 |
| Max. Negotiated Rate |
$1,508.40 |
| Rate for Payer: Adventist Health Commercial |
$335.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,173.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.40
|
| Rate for Payer: EPIC Health Plan Senior |
$670.40
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,064.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$988.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,676.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$335.20 |
| Max. Negotiated Rate |
$1,508.40 |
| Rate for Payer: Adventist Health Commercial |
$335.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,173.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.40
|
| Rate for Payer: EPIC Health Plan Senior |
$670.40
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,064.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$988.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
IP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$645.84 |
| Rate for Payer: Adventist Health Commercial |
$143.52
|
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Central Health Plan Commercial |
$574.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$502.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: EPIC Health Plan Senior |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$645.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$455.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$423.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Multiplan Commercial |
$538.20
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
OP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$645.84 |
| Rate for Payer: Adventist Health Commercial |
$143.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$435.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$609.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$394.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$538.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$347.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$417.43
|
| Rate for Payer: Blue Shield of California Commercial |
$454.96
|
| Rate for Payer: Blue Shield of California EPN |
$286.32
|
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Central Health Plan Commercial |
$574.08
|
| Rate for Payer: Cigna of CA HMO |
$459.26
|
| Rate for Payer: Cigna of CA PPO |
$531.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$609.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$609.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$609.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$502.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: EPIC Health Plan Senior |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$645.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$455.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$260.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$423.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$502.32
|
| Rate for Payer: Multiplan Commercial |
$538.20
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
| Rate for Payer: Riverside University Health System MISP |
$287.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$430.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$430.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$358.80
|
| Rate for Payer: United Healthcare All Other HMO |
$358.80
|
| Rate for Payer: United Healthcare HMO Rider |
$358.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$358.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$609.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$609.96
|
| Rate for Payer: Vantage Medical Group Senior |
$609.96
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,818.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.72 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$963.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,854.40
|
| Rate for Payer: Cigna of CA HMO |
$3,083.52
|
| Rate for Payer: Cigna of CA PPO |
$3,565.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,372.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$4,095.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,890.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,336.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$144.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,059.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$963.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,613.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,131.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$4,095.30
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,890.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,409.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,818.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$963.60 |
| Max. Negotiated Rate |
$4,336.20 |
| Rate for Payer: Adventist Health Commercial |
$963.60
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,854.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,372.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,927.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,927.20
|
| Rate for Payer: Galaxy Health WC |
$4,095.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,890.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,336.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,059.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,842.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$963.60
|
| Rate for Payer: Multiplan Commercial |
$3,613.50
|
| Rate for Payer: Networks By Design Commercial |
$3,131.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,095.30
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,818.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$963.60
|
| 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 |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| 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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,854.40
|
| Rate for Payer: Cigna of CA HMO |
$3,083.52
|
| Rate for Payer: Cigna of CA PPO |
$3,565.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,372.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$4,095.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,890.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,336.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,059.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$963.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,613.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,131.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$4,095.30
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,890.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,409.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,409.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,409.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,409.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,818.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$963.60 |
| Max. Negotiated Rate |
$4,336.20 |
| Rate for Payer: Adventist Health Commercial |
$963.60
|
| Rate for Payer: Cash Price |
$2,168.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,854.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,372.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,927.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,927.20
|
| Rate for Payer: Galaxy Health WC |
$4,095.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,890.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,336.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,059.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,842.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$963.60
|
| Rate for Payer: Multiplan Commercial |
$3,613.50
|
| Rate for Payer: Networks By Design Commercial |
$3,131.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,095.30
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
OP
|
$2,280.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
900501055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.76 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$456.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,026.00
|
| Rate for Payer: Cash Price |
$1,026.00
|
| Rate for Payer: Cash Price |
$1,026.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,824.00
|
| Rate for Payer: Cigna of CA HMO |
$1,459.20
|
| Rate for Payer: Cigna of CA PPO |
$1,687.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,596.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,938.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,368.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,052.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,447.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$456.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,710.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,482.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,938.00
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,368.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,140.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
