|
HC CT ABDOMEN W/WO CONT
|
Facility
|
OP
|
$3,505.00
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
909201929
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,154.50 |
| Rate for Payer: Adventist Health Commercial |
$701.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,747.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,058.49
|
| Rate for Payer: Blue Shield of California Commercial |
$2,127.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.48
|
| Rate for Payer: Cash Price |
$1,927.75
|
| Rate for Payer: Cash Price |
$1,927.75
|
| Rate for Payer: Cash Price |
$1,927.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,804.00
|
| Rate for Payer: Cigna of CA HMO |
$2,243.20
|
| Rate for Payer: Cigna of CA PPO |
$2,593.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,979.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,154.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$701.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,628.75
|
| Rate for Payer: Networks By Design Commercial |
$2,278.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,979.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,103.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,103.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
OP
|
$4,310.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,879.00 |
| Rate for Payer: Adventist Health Commercial |
$862.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,531.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,616.17
|
| Rate for Payer: Blue Shield of California EPN |
$1,711.07
|
| Rate for Payer: Cash Price |
$2,370.50
|
| Rate for Payer: Cash Price |
$2,370.50
|
| Rate for Payer: Cash Price |
$2,370.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,448.00
|
| Rate for Payer: Cigna of CA HMO |
$2,758.40
|
| Rate for Payer: Cigna of CA PPO |
$3,189.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,663.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,586.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,879.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$589.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,874.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$650.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$862.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$3,232.50
|
| Rate for Payer: Networks By Design Commercial |
$2,801.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,663.50
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,586.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,586.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
IP
|
$4,310.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$862.00 |
| Max. Negotiated Rate |
$3,879.00 |
| Rate for Payer: Adventist Health Commercial |
$862.00
|
| Rate for Payer: Cash Price |
$2,370.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,448.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,724.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,724.00
|
| Rate for Payer: Galaxy Health WC |
$3,663.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,586.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,879.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,874.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,642.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,667.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$862.00
|
| Rate for Payer: Multiplan Commercial |
$3,232.50
|
| Rate for Payer: Networks By Design Commercial |
$2,801.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,663.50
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
OP
|
$3,802.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$453.77 |
| Max. Negotiated Rate |
$3,421.80 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,754.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,232.91
|
| Rate for Payer: Blue Shield of California Commercial |
$2,307.81
|
| Rate for Payer: Blue Shield of California EPN |
$1,509.39
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: Cigna of CA HMO |
$2,433.28
|
| Rate for Payer: Cigna of CA PPO |
$2,813.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$605.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$668.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
IP
|
$3,802.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$760.40 |
| Max. Negotiated Rate |
$3,421.80 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.80
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
|
|
HC CT ANGIO ABDOMEN W/WO CONTRAST
|
Facility
|
OP
|
$3,890.00
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
909201808
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Adventist Health Commercial |
$778.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,284.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,361.23
|
| Rate for Payer: Blue Shield of California EPN |
$1,544.33
|
| Rate for Payer: Cash Price |
$2,139.50
|
| Rate for Payer: Cash Price |
$2,139.50
|
| Rate for Payer: Cash Price |
$2,139.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,112.00
|
| Rate for Payer: Cigna of CA HMO |
$2,489.60
|
| Rate for Payer: Cigna of CA PPO |
$2,878.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,306.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,334.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,501.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,594.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$778.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,917.50
|
| Rate for Payer: Networks By Design Commercial |
$2,528.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,306.50
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,334.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,334.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO ABDOMEN W/WO CONTRAST
|
Facility
|
IP
|
$3,890.00
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
909201808
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$778.00 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Adventist Health Commercial |
$778.00
|
| Rate for Payer: Cash Price |
$2,139.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,112.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,556.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,556.00
|
| Rate for Payer: Galaxy Health WC |
$3,306.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,334.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,501.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,594.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,482.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,407.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$778.00
|
| Rate for Payer: Multiplan Commercial |
$2,917.50
|
| Rate for Payer: Networks By Design Commercial |
$2,528.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,306.50
|
|
|
HC CT ANGIO CHEST W/WO CONTRAST
|
Facility
|
OP
|
$3,658.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
909201802
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,292.20 |
| Rate for Payer: Adventist Health Commercial |
$731.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,858.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,148.34
|
| Rate for Payer: Blue Shield of California Commercial |
$2,220.41
|
| Rate for Payer: Blue Shield of California EPN |
$1,452.23
|
| Rate for Payer: Cash Price |
$2,011.90
|
| Rate for Payer: Cash Price |
$2,011.90
|
| Rate for Payer: Cash Price |
$2,011.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,926.40
|
| Rate for Payer: Cigna of CA HMO |
$2,341.12
|
| Rate for Payer: Cigna of CA PPO |
$2,706.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,109.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,194.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,292.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$465.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,439.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$731.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,743.50
|
| Rate for Payer: Networks By Design Commercial |
$2,377.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,109.30
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,194.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,194.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO CHEST W/WO CONTRAST
|
Facility
|
IP
|
$3,658.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
909201802
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$731.60 |
| Max. Negotiated Rate |
$3,292.20 |
| Rate for Payer: Adventist Health Commercial |
$731.60
|
| Rate for Payer: Cash Price |
$2,011.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,926.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,463.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,463.20
|
| Rate for Payer: Galaxy Health WC |
$3,109.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,194.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,292.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,439.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,393.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,264.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$731.60
|
| Rate for Payer: Multiplan Commercial |
$2,743.50
|
| Rate for Payer: Networks By Design Commercial |
$2,377.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,109.30
|
|
|
HC CT ANGIO HEAD W/WO CONTRAST
|
Facility
|
IP
|
$4,285.00
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
909201800
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$857.00 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,714.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,714.00
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,858.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,632.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,652.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
|
|
HC CT ANGIO HEAD W/WO CONTRAST
|
Facility
|
OP
|
$4,285.00
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
909201800
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,516.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,600.99
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.14
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: Cigna of CA HMO |
$2,742.40
|
| Rate for Payer: Cigna of CA PPO |
$3,170.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,858.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,571.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,142.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,142.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,142.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO LOW EXT W/WO CONT
|
Facility
|
OP
|
$2,736.00
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
909201807
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,606.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,660.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,086.19
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: Cigna of CA HMO |
$1,751.04
|
| Rate for Payer: Cigna of CA PPO |
$2,024.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$543.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,824.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$600.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,641.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,641.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO LOW EXT W/WO CONT
|
Facility
|
IP
|
$2,736.00
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
909201807
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$547.20 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,094.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,094.40
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,824.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,042.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,693.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
|
|
HC CT ANGIO NECK W/WO CONTRAST
|
Facility
|
IP
|
$4,285.00
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
909201801
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$857.00 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,714.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,714.00
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,858.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,632.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,652.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
|
|
HC CT ANGIO NECK W/WO CONTRAST
|
Facility
|
OP
|
$4,285.00
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
909201801
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,516.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,600.99
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.14
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Cash Price |
$2,356.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: Cigna of CA HMO |
$2,742.40
|
| Rate for Payer: Cigna of CA PPO |
$3,170.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$456.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,858.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,571.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,142.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,142.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,142.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO PELVIS W/WO CONTRAST
|
Facility
|
OP
|
$3,097.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
909201803
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$2,787.30 |
| Rate for Payer: Adventist Health Commercial |
$619.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,818.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1,879.88
|
| Rate for Payer: Blue Shield of California EPN |
$1,229.51
|
| Rate for Payer: Cash Price |
$1,703.35
|
| Rate for Payer: Cash Price |
$1,703.35
|
| Rate for Payer: Cash Price |
$1,703.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,477.60
|
| Rate for Payer: Cigna of CA HMO |
$1,982.08
|
| Rate for Payer: Cigna of CA PPO |
$2,291.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,632.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,787.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$472.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,065.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,322.75
|
| Rate for Payer: Networks By Design Commercial |
$2,013.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,632.45
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,858.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,858.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO PELVIS W/WO CONTRAST
|
Facility
|
IP
|
$3,097.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
909201803
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$619.40 |
| Max. Negotiated Rate |
$2,787.30 |
| Rate for Payer: Adventist Health Commercial |
$619.40
|
| Rate for Payer: Cash Price |
$1,703.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,477.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,238.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,238.80
|
| Rate for Payer: Galaxy Health WC |
$2,632.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,787.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,065.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,179.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.40
|
| Rate for Payer: Multiplan Commercial |
$2,322.75
|
| Rate for Payer: Networks By Design Commercial |
$2,013.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,632.45
|
|
|
HC CT ANGIO UPP EXT W/WO CON
|
Facility
|
IP
|
$3,004.00
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
909201804
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$600.80 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,201.60
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,144.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,859.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
|
|
HC CT ANGIO UPP EXT W/WO CON
|
Facility
|
OP
|
$3,004.00
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
909201804
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,764.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,823.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,192.59
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: Cigna of CA HMO |
$1,922.56
|
| Rate for Payer: Cigna of CA PPO |
$2,222.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$500.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$553.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,802.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT BONE L-SPINE W CONTRAST
|
Facility
|
IP
|
$2,736.00
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
909201008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$547.20 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,094.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,094.40
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,824.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,042.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,693.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
|
|
HC CT BONE L-SPINE W CONTRAST
|
Facility
|
OP
|
$2,736.00
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
909201008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$280.50 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,458.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,606.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,660.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,086.19
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Cash Price |
$1,504.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: Cigna of CA HMO |
$1,751.04
|
| Rate for Payer: Cigna of CA PPO |
$2,024.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,824.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,641.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,641.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CT BONE L-SPINE W/O CONTRAST
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
909201007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$135.12 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| 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 |
$1,220.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,497.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,547.85
|
| Rate for Payer: Blue Shield of California EPN |
$1,012.35
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,040.00
|
| Rate for Payer: Cigna of CA HMO |
$1,632.00
|
| Rate for Payer: Cigna of CA PPO |
$1,887.00
|
| 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 |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,295.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$213.86
|
| 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 |
$1,700.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| 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 |
$1,912.50
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
| 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 |
$1,530.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,530.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| 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 CT BONE L-SPINE W/O CONTRAST
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
909201007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,040.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,020.00
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,295.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,700.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$971.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,578.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: Multiplan Commercial |
$1,912.50
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
|
|
HC CT BONE L-SPINE W/WO CONTRAST
|
Facility
|
OP
|
$3,004.00
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
909201009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,817.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,764.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,823.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,192.59
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: Cigna of CA HMO |
$1,922.56
|
| Rate for Payer: Cigna of CA PPO |
$2,222.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$330.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$364.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,802.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT BONE L-SPINE W/WO CONTRAST
|
Facility
|
IP
|
$3,004.00
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
909201009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$600.80 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Cash Price |
$1,652.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,201.60
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,144.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,859.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
|
