|
HC PARAFFIN BATH PT
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
905103109
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.92 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$199.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$176.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Central Health Plan Commercial |
$188.00
|
| Rate for Payer: Cigna of CA HMO |
$150.40
|
| Rate for Payer: Cigna of CA PPO |
$173.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$199.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.00
|
| Rate for Payer: EPIC Health Plan Senior |
$94.00
|
| Rate for Payer: Galaxy Health WC |
$199.75
|
| Rate for Payer: Global Benefits Group Commercial |
$141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$211.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$164.50
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: Networks By Design Commercial |
$152.75
|
| Rate for Payer: Prime Health Services Commercial |
$199.75
|
| Rate for Payer: Riverside University Health System MISP |
$94.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$199.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.75
|
| Rate for Payer: Vantage Medical Group Senior |
$199.75
|
|
|
HC PARAFFIN BATH PT COMM MCARE
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
900419066
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.92 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$199.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$176.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Central Health Plan Commercial |
$188.00
|
| Rate for Payer: Cigna of CA HMO |
$150.40
|
| Rate for Payer: Cigna of CA PPO |
$173.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$199.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.00
|
| Rate for Payer: EPIC Health Plan Senior |
$94.00
|
| Rate for Payer: Galaxy Health WC |
$199.75
|
| Rate for Payer: Global Benefits Group Commercial |
$141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$211.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$164.50
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: Networks By Design Commercial |
$152.75
|
| Rate for Payer: Prime Health Services Commercial |
$199.75
|
| Rate for Payer: Riverside University Health System MISP |
$94.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$199.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.75
|
| Rate for Payer: Vantage Medical Group Senior |
$199.75
|
|
|
HC PARAFFIN BATH PT COMM MCARE
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
900419066
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Central Health Plan Commercial |
$188.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.00
|
| Rate for Payer: EPIC Health Plan Senior |
$94.00
|
| Rate for Payer: Galaxy Health WC |
$199.75
|
| Rate for Payer: Global Benefits Group Commercial |
$141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$211.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.00
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: Networks By Design Commercial |
$152.75
|
| Rate for Payer: Prime Health Services Commercial |
$199.75
|
|
|
HC PARANASAL SINUS LTD
|
Facility
|
OP
|
$973.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$875.70 |
| Rate for Payer: Adventist Health Commercial |
$194.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.08
|
| Rate for Payer: Blue Shield of California Commercial |
$612.99
|
| Rate for Payer: Blue Shield of California EPN |
$386.28
|
| Rate for Payer: Cash Price |
$437.85
|
| Rate for Payer: Cash Price |
$437.85
|
| Rate for Payer: Central Health Plan Commercial |
$778.40
|
| Rate for Payer: Cigna of CA HMO |
$622.72
|
| Rate for Payer: Cigna of CA PPO |
$720.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$681.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$827.05
|
| Rate for Payer: Global Benefits Group Commercial |
$583.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$875.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$617.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$729.75
|
| Rate for Payer: Networks By Design Commercial |
$632.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$827.05
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$583.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$583.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC PARANASAL SINUS LTD
|
Facility
|
IP
|
$973.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$194.60 |
| Max. Negotiated Rate |
$875.70 |
| Rate for Payer: Adventist Health Commercial |
$194.60
|
| Rate for Payer: Cash Price |
$437.85
|
| Rate for Payer: Central Health Plan Commercial |
$778.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$681.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$389.20
|
| Rate for Payer: EPIC Health Plan Senior |
$389.20
|
| Rate for Payer: Galaxy Health WC |
$827.05
|
| Rate for Payer: Global Benefits Group Commercial |
$583.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$875.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$617.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$574.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.60
|
| Rate for Payer: Multiplan Commercial |
$729.75
|
| Rate for Payer: Networks By Design Commercial |
$632.45
|
| Rate for Payer: Prime Health Services Commercial |
$827.05
|
|
|
HC PARASITE SCREEN
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.90
|
| Rate for Payer: Blue Shield of California Commercial |
$28.35
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California EPN |
$17.86
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$31.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.77
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.65
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.05
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.98
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.98
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Medicare |
$12.70
|
| Rate for Payer: Prime Health Services Medicare |
$12.70
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC PARASITE SCREEN
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
915352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Blue Shield of California Commercial |
$193.28
|
| Rate for Payer: Blue Shield of California EPN |
$121.46
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
915352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.93 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.19
|
| Rate for Payer: Blue Shield of California Commercial |
$193.28
|
| Rate for Payer: Blue Shield of California EPN |
$121.46
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
905352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Blue Shield of California Commercial |
$193.28
|
| Rate for Payer: Blue Shield of California EPN |
$121.46
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
905352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.93 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.19
|
| Rate for Payer: Blue Shield of California Commercial |
$193.28
|
| Rate for Payer: Blue Shield of California EPN |
$121.46
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC PARATHYROID
|
Facility
|
IP
|
$1,204.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$240.80 |
| Max. Negotiated Rate |
$1,083.60 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Central Health Plan Commercial |
$963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$842.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$481.60
|
| Rate for Payer: Galaxy Health WC |
$1,023.40
|
| Rate for Payer: Global Benefits Group Commercial |
$722.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,083.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$764.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$710.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.80
|
| Rate for Payer: Multiplan Commercial |
$903.00
|
| Rate for Payer: Networks By Design Commercial |
$782.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,023.40
|
|
|
HC PARATHYROID
|
Facility
|
OP
|
$1,204.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$240.80 |
| Max. Negotiated Rate |
$1,838.16 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,834.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,838.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$700.37
|
| Rate for Payer: Blue Shield of California Commercial |
$758.52
|
| Rate for Payer: Blue Shield of California EPN |
$477.99
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Central Health Plan Commercial |
$963.20
|
| Rate for Payer: Cigna of CA HMO |
$770.56
|
| Rate for Payer: Cigna of CA PPO |
$890.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$842.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,023.40
|
| Rate for Payer: Global Benefits Group Commercial |
$722.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,083.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$536.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$764.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$592.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$903.00
|
| Rate for Payer: Networks By Design Commercial |
$782.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$1,023.40
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$722.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$722.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$824.42
|
| Rate for Payer: United Healthcare All Other HMO |
$824.42
|
| Rate for Payer: United Healthcare HMO Rider |
$824.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$824.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC PARATHYROID WITH PLANAR
|
Facility
|
OP
|
$2,197.00
|
|
|
Service Code
|
CPT 78072
|
| Hospital Charge Code |
900078072
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$439.40 |
| Max. Negotiated Rate |
$1,977.30 |
| Rate for Payer: Adventist Health Commercial |
$439.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$698.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,731.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$698.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,943.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,277.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,384.11
|
| Rate for Payer: Blue Shield of California EPN |
$872.21
|
| Rate for Payer: Cash Price |
$988.65
|
| Rate for Payer: Cash Price |
$988.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,757.60
|
| Rate for Payer: Cigna of CA HMO |
$1,406.08
|
| Rate for Payer: Cigna of CA PPO |
$1,625.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$768.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,537.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.28
|
| Rate for Payer: EPIC Health Plan Senior |
$768.18
|
| Rate for Payer: Galaxy Health WC |
$1,867.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,977.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,145.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$627.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$698.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,395.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$693.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$977.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$935.79
|
| Rate for Payer: Multiplan Commercial |
$1,647.75
|
| Rate for Payer: Networks By Design Commercial |
$1,428.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$698.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,867.45
|
| Rate for Payer: Prime Health Services Medicare |
$740.25
|
| Rate for Payer: Riverside University Health System MISP |
$768.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$824.42
|
| Rate for Payer: United Healthcare All Other HMO |
$824.42
|
| Rate for Payer: United Healthcare HMO Rider |
$824.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$824.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$698.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Vantage Medical Group Senior |
$698.35
|
|
|
HC PARATHYROID WITH PLANAR
|
Facility
|
IP
|
$2,197.00
|
|
|
Service Code
|
CPT 78072
|
| Hospital Charge Code |
900078072
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$439.40 |
| Max. Negotiated Rate |
$1,977.30 |
| Rate for Payer: Adventist Health Commercial |
$439.40
|
| Rate for Payer: Cash Price |
$988.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,757.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,537.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$878.80
|
| Rate for Payer: EPIC Health Plan Senior |
$878.80
|
| Rate for Payer: Galaxy Health WC |
$1,867.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,977.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,395.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,296.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.40
|
| Rate for Payer: Multiplan Commercial |
$1,647.75
|
| Rate for Payer: Networks By Design Commercial |
$1,428.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,867.45
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
IP
|
$25,018.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819771
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,003.60 |
| Max. Negotiated Rate |
$22,516.20 |
| Rate for Payer: Adventist Health Commercial |
$5,003.60
|
| Rate for Payer: Cash Price |
$11,258.10
|
| Rate for Payer: Central Health Plan Commercial |
$20,014.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,512.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,007.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,007.20
|
| Rate for Payer: Galaxy Health WC |
$21,265.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,010.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,516.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,886.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,760.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,003.60
|
| Rate for Payer: Multiplan Commercial |
$18,763.50
|
| Rate for Payer: Networks By Design Commercial |
$16,261.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,265.30
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
OP
|
$25,018.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819771
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,003.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,113.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,552.97
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$11,258.10
|
| Rate for Payer: Cash Price |
$11,258.10
|
| Rate for Payer: Cash Price |
$11,258.10
|
| Rate for Payer: Central Health Plan Commercial |
$20,014.40
|
| Rate for Payer: Cigna of CA HMO |
$16,261.70
|
| Rate for Payer: Cigna of CA PPO |
$18,513.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,512.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$21,265.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,010.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,516.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,886.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,003.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$18,763.50
|
| Rate for Payer: Networks By Design Commercial |
$16,261.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$21,265.30
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,010.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,010.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC PARENT INFANT GRP OT 60 MIN
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905104034
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$85.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$212.85
|
| Rate for Payer: Cash Price |
$212.85
|
| Rate for Payer: Cash Price |
$212.85
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$331.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$300.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
|
HC PARENT INFANT GRP OT 60 MIN
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905104034
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Adventist Health Commercial |
$94.60
|
| Rate for Payer: Cash Price |
$212.85
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$331.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$300.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.60
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
|
|
HC PART FT SHOE INSERT W/TOE FILL
|
Facility
|
OP
|
$1,032.00
|
|
|
Service Code
|
CPT L5000
|
| Hospital Charge Code |
905355000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$336.17 |
| Max. Negotiated Rate |
$928.80 |
| Rate for Payer: Adventist Health Commercial |
$423.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$877.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$567.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$774.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$600.31
|
| Rate for Payer: Blue Shield of California Commercial |
$827.66
|
| Rate for Payer: Blue Shield of California EPN |
$520.13
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Central Health Plan Commercial |
$825.60
|
| Rate for Payer: Cigna of CA HMO |
$722.40
|
| Rate for Payer: Cigna of CA PPO |
$722.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$877.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$877.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$877.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$722.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$412.80
|
| Rate for Payer: Galaxy Health WC |
$877.20
|
| Rate for Payer: Global Benefits Group Commercial |
$619.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$928.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$655.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$608.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$423.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$722.40
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
| Rate for Payer: Networks By Design Commercial |
$516.00
|
| Rate for Payer: Prime Health Services Commercial |
$877.20
|
| Rate for Payer: Riverside University Health System MISP |
$412.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$619.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$619.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$387.31
|
| Rate for Payer: United Healthcare All Other HMO |
$376.99
|
| Rate for Payer: United Healthcare HMO Rider |
$368.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$877.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$877.20
|
| Rate for Payer: Vantage Medical Group Senior |
$877.20
|
|
|
HC PART FT SHOE INSERT W/TOE FILL
|
Facility
|
OP
|
$1,032.00
|
|
|
Service Code
|
CPT L5000
|
| Hospital Charge Code |
915355000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$336.17 |
| Max. Negotiated Rate |
$928.80 |
| Rate for Payer: Adventist Health Commercial |
$423.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$877.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$567.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$774.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$600.31
|
| Rate for Payer: Blue Shield of California Commercial |
$827.66
|
| Rate for Payer: Blue Shield of California EPN |
$520.13
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Central Health Plan Commercial |
$825.60
|
| Rate for Payer: Cigna of CA HMO |
$722.40
|
| Rate for Payer: Cigna of CA PPO |
$722.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$877.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$877.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$877.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$722.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$412.80
|
| Rate for Payer: Galaxy Health WC |
$877.20
|
| Rate for Payer: Global Benefits Group Commercial |
$619.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$928.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$655.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$608.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$423.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$722.40
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
| Rate for Payer: Networks By Design Commercial |
$516.00
|
| Rate for Payer: Prime Health Services Commercial |
$877.20
|
| Rate for Payer: Riverside University Health System MISP |
$412.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$619.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$619.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$387.31
|
| Rate for Payer: United Healthcare All Other HMO |
$376.99
|
| Rate for Payer: United Healthcare HMO Rider |
$368.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$877.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$877.20
|
| Rate for Payer: Vantage Medical Group Senior |
$877.20
|
|
|
HC PART FT SHOE INSERT W/TOE FILL
|
Facility
|
IP
|
$1,032.00
|
|
|
Service Code
|
CPT L5000
|
| Hospital Charge Code |
915355000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$928.80 |
| Rate for Payer: Adventist Health Commercial |
$206.40
|
| Rate for Payer: Blue Shield of California Commercial |
$827.66
|
| Rate for Payer: Blue Shield of California EPN |
$520.13
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Central Health Plan Commercial |
$825.60
|
| Rate for Payer: Cigna of CA HMO |
$722.40
|
| Rate for Payer: Cigna of CA PPO |
$722.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$722.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$412.80
|
| Rate for Payer: Galaxy Health WC |
$877.20
|
| Rate for Payer: Global Benefits Group Commercial |
$619.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$928.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$655.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$608.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.40
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
| Rate for Payer: Networks By Design Commercial |
$670.80
|
| Rate for Payer: Prime Health Services Commercial |
$877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$387.31
|
| Rate for Payer: United Healthcare All Other HMO |
$376.99
|
| Rate for Payer: United Healthcare HMO Rider |
$368.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.98
|
|
|
HC PART FT SHOE INSERT W/TOE FILL
|
Facility
|
IP
|
$1,032.00
|
|
|
Service Code
|
CPT L5000
|
| Hospital Charge Code |
905355000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$928.80 |
| Rate for Payer: Adventist Health Commercial |
$206.40
|
| Rate for Payer: Blue Shield of California Commercial |
$827.66
|
| Rate for Payer: Blue Shield of California EPN |
$520.13
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Central Health Plan Commercial |
$825.60
|
| Rate for Payer: Cigna of CA HMO |
$722.40
|
| Rate for Payer: Cigna of CA PPO |
$722.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$722.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$412.80
|
| Rate for Payer: Galaxy Health WC |
$877.20
|
| Rate for Payer: Global Benefits Group Commercial |
$619.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$928.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$655.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$608.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.40
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
| Rate for Payer: Networks By Design Commercial |
$670.80
|
| Rate for Payer: Prime Health Services Commercial |
$877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$387.31
|
| Rate for Payer: United Healthcare All Other HMO |
$376.99
|
| Rate for Payer: United Healthcare HMO Rider |
$368.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.98
|
|
|
HC PART HAND LITTLE &OR RING FING
|
Facility
|
IP
|
$3,699.00
|
|
|
Service Code
|
CPT L6010
|
| Hospital Charge Code |
905356010
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$739.80 |
| Max. Negotiated Rate |
$3,329.10 |
| Rate for Payer: Adventist Health Commercial |
$739.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,966.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,864.30
|
| Rate for Payer: Cash Price |
$1,664.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,959.20
|
| Rate for Payer: Cigna of CA HMO |
$2,589.30
|
| Rate for Payer: Cigna of CA PPO |
$2,589.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,589.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,479.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,479.60
|
| Rate for Payer: Galaxy Health WC |
$3,144.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,219.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,329.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,348.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,182.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$739.80
|
| Rate for Payer: Multiplan Commercial |
$2,774.25
|
| Rate for Payer: Networks By Design Commercial |
$2,404.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,144.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,388.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,351.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,322.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,211.42
|
|
|
HC PART HAND LITTLE &OR RING FING
|
Facility
|
OP
|
$3,699.00
|
|
|
Service Code
|
CPT L6010
|
| Hospital Charge Code |
905356010
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,211.42 |
| Max. Negotiated Rate |
$3,329.10 |
| Rate for Payer: Adventist Health Commercial |
$1,516.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,144.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,034.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,774.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,151.71
|
| Rate for Payer: Blue Shield of California Commercial |
$2,966.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,864.30
|
| Rate for Payer: Cash Price |
$1,664.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,959.20
|
| Rate for Payer: Cigna of CA HMO |
$2,589.30
|
| Rate for Payer: Cigna of CA PPO |
$2,589.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,144.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,144.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,144.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,589.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,479.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,479.60
|
| Rate for Payer: Galaxy Health WC |
$3,144.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,219.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,329.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,348.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,342.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,182.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,516.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,589.30
|
| Rate for Payer: Multiplan Commercial |
$2,774.25
|
| Rate for Payer: Networks By Design Commercial |
$1,849.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,144.15
|
| Rate for Payer: Riverside University Health System MISP |
$1,479.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,219.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,219.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,388.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,351.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,322.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,211.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,144.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,144.15
|
| Rate for Payer: Vantage Medical Group Senior |
$3,144.15
|
|