|
HC BONE AGE
|
Facility
|
IP
|
$831.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.20 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Cash Price |
$457.05
|
| Rate for Payer: Central Health Plan Commercial |
$664.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$332.40
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$554.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$514.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.20
|
| Rate for Payer: Multiplan Commercial |
$623.25
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
|
|
HC BONE AGE
|
Facility
|
OP
|
$831.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$504.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.05
|
| Rate for Payer: Blue Shield of California Commercial |
$504.42
|
| Rate for Payer: Blue Shield of California EPN |
$329.91
|
| Rate for Payer: Cash Price |
$457.05
|
| Rate for Payer: Cash Price |
$457.05
|
| Rate for Payer: Central Health Plan Commercial |
$664.80
|
| Rate for Payer: Cigna of CA HMO |
$531.84
|
| Rate for Payer: Cigna of CA PPO |
$614.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$554.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$623.25
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
IP
|
$7,881.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,576.20 |
| Max. Negotiated Rate |
$7,092.90 |
| Rate for Payer: Adventist Health Commercial |
$1,576.20
|
| Rate for Payer: Cash Price |
$4,334.55
|
| Rate for Payer: Central Health Plan Commercial |
$6,304.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,152.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,152.40
|
| Rate for Payer: Galaxy Health WC |
$6,698.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,728.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,092.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,256.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,002.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,878.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.20
|
| Rate for Payer: Multiplan Commercial |
$5,910.75
|
| Rate for Payer: Networks By Design Commercial |
$5,122.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,698.85
|
|
|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
OP
|
$7,881.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.14 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,576.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,334.55
|
| Rate for Payer: Cash Price |
$4,334.55
|
| Rate for Payer: Cash Price |
$4,334.55
|
| Rate for Payer: Central Health Plan Commercial |
$6,304.80
|
| Rate for Payer: Cigna of CA HMO |
$5,043.84
|
| Rate for Payer: Cigna of CA PPO |
$5,831.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$6,698.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,728.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,092.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$256.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,256.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$5,910.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$5,122.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,698.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,728.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
IP
|
$3,643.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$728.60 |
| Max. Negotiated Rate |
$3,278.70 |
| Rate for Payer: Adventist Health Commercial |
$728.60
|
| Rate for Payer: Cash Price |
$2,003.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,914.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,457.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,457.20
|
| Rate for Payer: Galaxy Health WC |
$3,096.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,185.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,278.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,429.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,387.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,255.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.60
|
| Rate for Payer: Multiplan Commercial |
$2,732.25
|
| Rate for Payer: Networks By Design Commercial |
$2,367.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,096.55
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
OP
|
$3,643.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.65 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$728.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,003.65
|
| Rate for Payer: Cash Price |
$2,003.65
|
| Rate for Payer: Cash Price |
$2,003.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,914.40
|
| Rate for Payer: Cigna of CA HMO |
$2,331.52
|
| Rate for Payer: Cigna of CA PPO |
$2,695.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$3,096.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,185.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,278.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$146.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,429.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$2,732.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,367.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,096.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,185.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Blue Shield of California Commercial |
$622.26
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$367.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$445.73
|
| Rate for Payer: Blue Shield of California Commercial |
$622.26
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: InnovAge PACE Commercial |
$402.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$1,618.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.08 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$323.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$783.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$950.25
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$889.90
|
| Rate for Payer: Cash Price |
$889.90
|
| Rate for Payer: Cash Price |
$889.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,294.40
|
| Rate for Payer: Cigna of CA HMO |
$1,035.52
|
| Rate for Payer: Cigna of CA PPO |
$1,197.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,375.30
|
| Rate for Payer: Global Benefits Group Commercial |
$970.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,456.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,079.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$1,213.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,051.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,375.30
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$970.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$1,618.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.60 |
| Max. Negotiated Rate |
$1,456.20 |
| Rate for Payer: Adventist Health Commercial |
$323.60
|
| Rate for Payer: Cash Price |
$889.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$647.20
|
| Rate for Payer: EPIC Health Plan Senior |
$647.20
|
| Rate for Payer: Galaxy Health WC |
$1,375.30
|
| Rate for Payer: Global Benefits Group Commercial |
$970.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,456.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,079.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$616.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,001.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.60
|
| Rate for Payer: Multiplan Commercial |
$1,213.50
|
| Rate for Payer: Networks By Design Commercial |
$1,051.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,375.30
|
|
|
HC BONE LENGTH
|
Facility
|
IP
|
$1,378.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$1,240.20 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Cash Price |
$757.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,102.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$551.20
|
| Rate for Payer: EPIC Health Plan Senior |
$551.20
|
| Rate for Payer: Galaxy Health WC |
$1,171.30
|
| Rate for Payer: Global Benefits Group Commercial |
$826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,240.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$919.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$852.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.60
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
| Rate for Payer: Networks By Design Commercial |
$895.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,171.30
|
|
|
HC BONE LENGTH
|
Facility
|
OP
|
$1,378.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.37 |
| Max. Negotiated Rate |
$1,240.20 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$836.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$164.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.37
|
| Rate for Payer: Blue Shield of California Commercial |
$836.45
|
| Rate for Payer: Blue Shield of California EPN |
$547.07
|
| Rate for Payer: Cash Price |
$757.90
|
| Rate for Payer: Cash Price |
$757.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,102.40
|
| Rate for Payer: Cigna of CA HMO |
$881.92
|
| Rate for Payer: Cigna of CA PPO |
$1,019.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,171.30
|
| Rate for Payer: Global Benefits Group Commercial |
$826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,240.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$55.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$919.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
| Rate for Payer: Networks By Design Commercial |
$895.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,171.30
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$826.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$826.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
OP
|
$4,855.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$265.10 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,636.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,350.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,851.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Cigna of CA HMO |
$3,107.20
|
| Rate for Payer: Cigna of CA PPO |
$3,592.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$265.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,238.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$292.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,913.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| 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 |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
IP
|
$4,855.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$971.00 |
| Max. Negotiated Rate |
$4,369.50 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,942.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,942.00
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,238.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,849.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,005.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
OP
|
$3,014.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.69 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$602.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,459.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,770.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,657.70
|
| Rate for Payer: Cash Price |
$1,657.70
|
| Rate for Payer: Cash Price |
$1,657.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,411.20
|
| Rate for Payer: Cigna of CA HMO |
$1,928.96
|
| Rate for Payer: Cigna of CA PPO |
$2,230.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$2,561.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,808.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,712.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$315.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,010.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$602.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$2,260.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,959.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$2,561.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,808.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
IP
|
$3,014.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$602.80 |
| Max. Negotiated Rate |
$2,712.60 |
| Rate for Payer: Adventist Health Commercial |
$602.80
|
| Rate for Payer: Cash Price |
$1,657.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,411.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,205.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,205.60
|
| Rate for Payer: Galaxy Health WC |
$2,561.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,808.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,712.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,010.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,148.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,865.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$602.80
|
| Rate for Payer: Multiplan Commercial |
$2,260.50
|
| Rate for Payer: Networks By Design Commercial |
$1,959.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,561.90
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
OP
|
$4,855.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.83 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,350.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,851.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Cigna of CA HMO |
$3,107.20
|
| Rate for Payer: Cigna of CA PPO |
$3,592.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,238.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,913.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
IP
|
$4,855.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$971.00 |
| Max. Negotiated Rate |
$4,369.50 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Cash Price |
$2,670.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,942.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,942.00
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,238.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,849.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,005.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$259.40 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,037.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$518.80
|
| Rate for Payer: Galaxy Health WC |
$1,102.45
|
| Rate for Payer: Global Benefits Group Commercial |
$778.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,167.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$865.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$494.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$802.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.40
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
| Rate for Payer: Networks By Design Commercial |
$843.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,102.45
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$510.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$787.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$761.73
|
| Rate for Payer: Blue Shield of California Commercial |
$787.28
|
| Rate for Payer: Blue Shield of California EPN |
$514.91
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,037.60
|
| Rate for Payer: Cigna of CA HMO |
$830.08
|
| Rate for Payer: Cigna of CA PPO |
$959.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$1,102.45
|
| Rate for Payer: Global Benefits Group Commercial |
$778.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,167.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$160.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: InnovAge PACE Commercial |
$765.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$865.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
| Rate for Payer: Networks By Design Commercial |
$843.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$510.57
|
| Rate for Payer: Prime Health Services Commercial |
$1,102.45
|
| Rate for Payer: Prime Health Services Medicare |
$541.20
|
| Rate for Payer: Riverside University Health System MISP |
$561.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$778.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$778.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$654.98
|
| Rate for Payer: United Healthcare All Other HMO |
$654.98
|
| Rate for Payer: United Healthcare HMO Rider |
$654.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$654.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
OP
|
$1,647.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$139.17 |
| Max. Negotiated Rate |
$1,482.30 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$510.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,000.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$506.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$967.28
|
| Rate for Payer: Blue Shield of California Commercial |
$999.73
|
| Rate for Payer: Blue Shield of California EPN |
$653.86
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,317.60
|
| Rate for Payer: Cigna of CA HMO |
$1,054.08
|
| Rate for Payer: Cigna of CA PPO |
$1,218.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$1,399.95
|
| Rate for Payer: Global Benefits Group Commercial |
$988.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,482.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$139.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: InnovAge PACE Commercial |
$765.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,098.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$1,235.25
|
| Rate for Payer: Networks By Design Commercial |
$1,070.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$510.57
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.95
|
| Rate for Payer: Prime Health Services Medicare |
$541.20
|
| Rate for Payer: Riverside University Health System MISP |
$561.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$988.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$988.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.16
|
| Rate for Payer: United Healthcare All Other HMO |
$632.16
|
| Rate for Payer: United Healthcare HMO Rider |
$632.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.16
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
IP
|
$1,647.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$329.40 |
| Max. Negotiated Rate |
$1,482.30 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,317.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.80
|
| Rate for Payer: EPIC Health Plan Senior |
$658.80
|
| Rate for Payer: Galaxy Health WC |
$1,399.95
|
| Rate for Payer: Global Benefits Group Commercial |
$988.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,482.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,098.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$627.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,019.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.40
|
| Rate for Payer: Multiplan Commercial |
$1,235.25
|
| Rate for Payer: Networks By Design Commercial |
$1,070.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.95
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
IP
|
$2,904.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$580.80 |
| Max. Negotiated Rate |
$2,613.60 |
| Rate for Payer: Adventist Health Commercial |
$580.80
|
| Rate for Payer: Cash Price |
$1,597.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,323.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,161.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,161.60
|
| Rate for Payer: Galaxy Health WC |
$2,468.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,742.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,613.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,936.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,106.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,797.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Multiplan Commercial |
$2,178.00
|
| Rate for Payer: Networks By Design Commercial |
$1,887.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,468.40
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
OP
|
$2,904.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$242.57 |
| Max. Negotiated Rate |
$2,613.60 |
| Rate for Payer: Adventist Health Commercial |
$580.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$510.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,763.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$867.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,705.52
|
| Rate for Payer: Blue Shield of California Commercial |
$1,762.73
|
| Rate for Payer: Blue Shield of California EPN |
$1,152.89
|
| Rate for Payer: Cash Price |
$1,597.20
|
| Rate for Payer: Cash Price |
$1,597.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,323.20
|
| Rate for Payer: Cigna of CA HMO |
$1,858.56
|
| Rate for Payer: Cigna of CA PPO |
$2,148.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$2,468.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,742.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,613.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$242.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: InnovAge PACE Commercial |
$765.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,936.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$2,178.00
|
| Rate for Payer: Networks By Design Commercial |
$1,887.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$510.57
|
| Rate for Payer: Prime Health Services Commercial |
$2,468.40
|
| Rate for Payer: Prime Health Services Medicare |
$541.20
|
| Rate for Payer: Riverside University Health System MISP |
$561.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,742.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,742.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.16
|
| Rate for Payer: United Healthcare All Other HMO |
$632.16
|
| Rate for Payer: United Healthcare HMO Rider |
$632.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.16
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE SPECT
|
Facility
|
OP
|
$3,089.00
|
|
|
Service Code
|
CPT 78320
|
| Hospital Charge Code |
909301369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$617.80 |
| Max. Negotiated Rate |
$2,780.10 |
| Rate for Payer: Adventist Health Commercial |
$617.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,875.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,625.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,698.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,316.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,814.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1,875.02
|
| Rate for Payer: Blue Shield of California EPN |
$1,226.33
|
| Rate for Payer: Cash Price |
$1,698.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,471.20
|
| Rate for Payer: Cigna of CA HMO |
$1,976.96
|
| Rate for Payer: Cigna of CA PPO |
$2,285.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,625.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,625.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,625.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,235.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,235.60
|
| Rate for Payer: Galaxy Health WC |
$2,625.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,853.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,780.10
|
| Rate for Payer: InnovAge PACE Commercial |
$1,544.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,060.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,176.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,912.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,162.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,162.30
|
| Rate for Payer: Multiplan Commercial |
$2,316.75
|
| Rate for Payer: Networks By Design Commercial |
$2,007.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,625.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,235.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,853.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,853.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,544.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,544.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,544.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,625.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,625.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,625.65
|
|
