|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,760.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$3,384.00 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,384.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,507.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,432.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,327.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.00
|
| Rate for Payer: Multiplan Commercial |
$2,820.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,760.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$148.56 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,008.00
|
| Rate for Payer: Cigna of CA HMO |
$2,444.00
|
| Rate for Payer: Cigna of CA PPO |
$2,782.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,384.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$148.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,507.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$2,820.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,256.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,256.00
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$791.60 |
| Max. Negotiated Rate |
$3,562.20 |
| Rate for Payer: Adventist Health Commercial |
$791.60
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,166.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,583.20
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,562.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,508.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,450.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$791.60
|
| Rate for Payer: Multiplan Commercial |
$2,968.50
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$148.56 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$791.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,166.40
|
| Rate for Payer: Cigna of CA HMO |
$2,572.70
|
| Rate for Payer: Cigna of CA PPO |
$2,928.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,562.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$148.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$791.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$2,968.50
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,374.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,374.80
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,760.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$3,384.00 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,384.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,507.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,432.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,327.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.00
|
| Rate for Payer: Multiplan Commercial |
$2,820.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
IP
|
$3,760.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$3,384.00 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,384.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,507.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,432.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,327.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.00
|
| Rate for Payer: Multiplan Commercial |
$2,820.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
OP
|
$3,760.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.56 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$6,372.03
|
| 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 |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,008.00
|
| Rate for Payer: Cigna of CA HMO |
$2,406.40
|
| Rate for Payer: Cigna of CA PPO |
$2,782.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,384.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$148.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,507.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$2,820.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,256.00
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: Cigna of CA HMO |
$4,858.88
|
| Rate for Payer: Cigna of CA PPO |
$5,618.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,555.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,796.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,796.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,796.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,518.40 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,036.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,036.80
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,892.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,518.40 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,036.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,036.80
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,892.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$6,602.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,320.40 |
| Max. Negotiated Rate |
$5,941.80 |
| Rate for Payer: Adventist Health Commercial |
$1,320.40
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,640.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,640.80
|
| Rate for Payer: Galaxy Health WC |
$5,611.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,961.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,941.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,515.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,320.40
|
| Rate for Payer: Multiplan Commercial |
$4,951.50
|
| Rate for Payer: Networks By Design Commercial |
$4,291.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,611.70
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,518.40 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,036.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,036.80
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,892.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$6,372.03
|
| 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 |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: Cigna of CA HMO |
$4,858.88
|
| Rate for Payer: Cigna of CA PPO |
$5,618.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,555.20
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$6,602.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$1,320.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$6,372.03
|
| 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 |
$2,970.90
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,281.60
|
| Rate for Payer: Cigna of CA HMO |
$4,225.28
|
| Rate for Payer: Cigna of CA PPO |
$4,885.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$5,611.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,961.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,941.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,320.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$4,951.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,291.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,611.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,961.20
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$7,592.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$6,832.80 |
| Rate for Payer: Adventist Health Commercial |
$1,518.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$6,372.03
|
| 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 |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Cash Price |
$3,416.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,073.60
|
| Rate for Payer: Cigna of CA HMO |
$4,858.88
|
| Rate for Payer: Cigna of CA PPO |
$5,618.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$6,453.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,555.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,832.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,063.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,518.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,694.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,934.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,453.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,555.20
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$26,026.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$519.34 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,205.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,122.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,314.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,519.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,601.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,285.07
|
| 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 |
$11,711.70
|
| Rate for Payer: Cash Price |
$11,711.70
|
| Rate for Payer: Cash Price |
$11,711.70
|
| Rate for Payer: Central Health Plan Commercial |
$20,820.80
|
| Rate for Payer: Cigna of CA HMO |
$16,656.64
|
| Rate for Payer: Cigna of CA PPO |
$19,259.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,122.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,122.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,122.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,410.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,410.40
|
| Rate for Payer: Galaxy Health WC |
$22,122.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15,615.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,423.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$519.34
|
| Rate for Payer: InnovAge PACE Commercial |
$13,013.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,359.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,110.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,205.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,218.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,218.20
|
| Rate for Payer: Multiplan Commercial |
$19,519.50
|
| Rate for Payer: Networks By Design Commercial |
$16,916.90
|
| Rate for Payer: Prime Health Services Commercial |
$22,122.10
|
| Rate for Payer: Riverside University Health System MISP |
$10,410.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,615.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$22,122.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,122.10
|
| Rate for Payer: Vantage Medical Group Senior |
$22,122.10
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$519.34 |
| Max. Negotiated Rate |
$27,557.10 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,840.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,964.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,825.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,982.54
|
| 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 |
$13,778.55
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Central Health Plan Commercial |
$24,495.20
|
| Rate for Payer: Cigna of CA HMO |
$19,596.16
|
| Rate for Payer: Cigna of CA PPO |
$22,658.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,026.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,026.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,247.60
|
| Rate for Payer: Galaxy Health WC |
$26,026.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,557.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$519.34
|
| Rate for Payer: InnovAge PACE Commercial |
$15,309.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,422.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,953.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,123.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,433.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,433.30
|
| Rate for Payer: Multiplan Commercial |
$22,964.25
|
| Rate for Payer: Networks By Design Commercial |
$19,902.35
|
| Rate for Payer: Prime Health Services Commercial |
$26,026.15
|
| Rate for Payer: Riverside University Health System MISP |
$12,247.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,371.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Senior |
$26,026.15
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$26,026.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,205.20 |
| Max. Negotiated Rate |
$23,423.40 |
| Rate for Payer: Adventist Health Commercial |
$5,205.20
|
| Rate for Payer: Cash Price |
$11,711.70
|
| Rate for Payer: Central Health Plan Commercial |
$20,820.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,410.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,410.40
|
| Rate for Payer: Galaxy Health WC |
$22,122.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15,615.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,423.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,359.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,915.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,110.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,205.20
|
| Rate for Payer: Multiplan Commercial |
$19,519.50
|
| Rate for Payer: Networks By Design Commercial |
$16,916.90
|
| Rate for Payer: Prime Health Services Commercial |
$22,122.10
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,123.80 |
| Max. Negotiated Rate |
$27,557.10 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Central Health Plan Commercial |
$24,495.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,247.60
|
| Rate for Payer: Galaxy Health WC |
$26,026.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,557.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,422.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,665.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,953.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,123.80
|
| Rate for Payer: Multiplan Commercial |
$22,964.25
|
| Rate for Payer: Networks By Design Commercial |
$19,902.35
|
| Rate for Payer: Prime Health Services Commercial |
$26,026.15
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
IP
|
$15,845.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,169.00 |
| Max. Negotiated Rate |
$14,260.50 |
| Rate for Payer: Adventist Health Commercial |
$3,169.00
|
| Rate for Payer: Cash Price |
$7,130.25
|
| Rate for Payer: Central Health Plan Commercial |
$12,676.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,338.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,338.00
|
| Rate for Payer: Galaxy Health WC |
$13,468.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,507.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,260.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,568.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,036.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,808.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,169.00
|
| Rate for Payer: Multiplan Commercial |
$11,883.75
|
| Rate for Payer: Networks By Design Commercial |
$10,299.25
|
| Rate for Payer: Prime Health Services Commercial |
$13,468.25
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
OP
|
$15,845.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$335.55 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$3,169.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,484.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| 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 |
$7,144.49
|
| 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 |
$7,130.25
|
| Rate for Payer: Cash Price |
$7,130.25
|
| Rate for Payer: Cash Price |
$7,130.25
|
| Rate for Payer: Central Health Plan Commercial |
$12,676.00
|
| Rate for Payer: Cigna of CA HMO |
$10,140.80
|
| Rate for Payer: Cigna of CA PPO |
$11,725.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,053.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4,484.02
|
| Rate for Payer: Galaxy Health WC |
$13,468.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,507.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,260.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,353.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$335.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: InnovAge PACE Commercial |
$6,726.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,568.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,484.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,169.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,008.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,008.59
|
| Rate for Payer: Multiplan Commercial |
$11,883.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$10,299.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Preferred Health Network WC |
$7,290.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,468.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,753.06
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$4,932.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,507.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,484.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
IP
|
$18,275.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,655.00 |
| Max. Negotiated Rate |
$16,447.50 |
| Rate for Payer: Adventist Health Commercial |
$3,655.00
|
| Rate for Payer: Cash Price |
$8,223.75
|
| Rate for Payer: Central Health Plan Commercial |
$14,620.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,310.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,310.00
|
| Rate for Payer: Galaxy Health WC |
$15,533.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,965.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,447.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,189.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,962.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,312.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,655.00
|
| Rate for Payer: Multiplan Commercial |
$13,706.25
|
| Rate for Payer: Networks By Design Commercial |
$11,878.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,533.75
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
OP
|
$18,275.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,030.97 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$3,655.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,484.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| 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 |
$7,144.49
|
| 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 |
$8,223.75
|
| Rate for Payer: Cash Price |
$8,223.75
|
| Rate for Payer: Cash Price |
$8,223.75
|
| Rate for Payer: Central Health Plan Commercial |
$14,620.00
|
| Rate for Payer: Cigna of CA HMO |
$11,696.00
|
| Rate for Payer: Cigna of CA PPO |
$13,523.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,053.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4,484.02
|
| Rate for Payer: Galaxy Health WC |
$15,533.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,965.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,447.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,353.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,030.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: InnovAge PACE Commercial |
$6,726.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,189.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,484.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,655.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,008.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,008.59
|
| Rate for Payer: Multiplan Commercial |
$13,706.25
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$11,878.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Preferred Health Network WC |
$7,290.30
|
| Rate for Payer: Prime Health Services Commercial |
$15,533.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,753.06
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$4,932.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,965.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,484.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
IP
|
$12,464.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,492.80 |
| Max. Negotiated Rate |
$11,217.60 |
| Rate for Payer: Adventist Health Commercial |
$2,492.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,971.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,985.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,985.60
|
| Rate for Payer: Galaxy Health WC |
$10,594.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,478.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,217.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,313.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,748.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,715.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,492.80
|
| Rate for Payer: Multiplan Commercial |
$9,348.00
|
| Rate for Payer: Networks By Design Commercial |
$8,101.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,594.40
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
OP
|
$12,464.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.06 |
| Max. Negotiated Rate |
$11,217.60 |
| Rate for Payer: Adventist Health Commercial |
$2,492.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,971.20
|
| Rate for Payer: Cigna of CA HMO |
$7,976.96
|
| Rate for Payer: Cigna of CA PPO |
$9,223.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$10,594.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,478.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,217.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,313.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,492.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$9,348.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,101.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$10,594.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,478.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,232.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,232.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,232.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,232.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
