|
BROMFENAC 0.09 % EYE DROPS [41146]
|
Facility
IP
|
$100.56
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
NDG41146B
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.11 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$75.42
|
| Rate for Payer: Blue Shield of California Commercial |
$94.27
|
| Rate for Payer: Blue Shield of California Commercial |
$94.28
|
| Rate for Payer: Blue Shield of California EPN |
$67.12
|
| Rate for Payer: Blue Shield of California EPN |
$67.12
|
| Rate for Payer: Blue Shield of California EPN |
$53.70
|
| Rate for Payer: Cash Price |
$56.57
|
| Rate for Payer: Cash Price |
$45.25
|
| Rate for Payer: Cash Price |
$45.25
|
| Rate for Payer: Cash Price |
$56.56
|
| Rate for Payer: Cash Price |
$56.57
|
| Rate for Payer: Cash Price |
$56.56
|
| Rate for Payer: Central Health Plan Commercial |
$80.45
|
| Rate for Payer: Central Health Plan Commercial |
$100.56
|
| Rate for Payer: Central Health Plan Commercial |
$100.55
|
| Rate for Payer: Cigna of CA HMO |
$87.99
|
| Rate for Payer: Cigna of CA HMO |
$70.39
|
| Rate for Payer: Cigna of CA HMO |
$87.98
|
| Rate for Payer: Cigna of CA PPO |
$70.39
|
| Rate for Payer: Cigna of CA PPO |
$87.99
|
| Rate for Payer: Cigna of CA PPO |
$87.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.22
|
| Rate for Payer: Galaxy Health WC |
$85.48
|
| Rate for Payer: Galaxy Health WC |
$106.84
|
| Rate for Payer: Galaxy Health WC |
$106.84
|
| Rate for Payer: Global Benefits Group Commercial |
$75.41
|
| Rate for Payer: Global Benefits Group Commercial |
$75.42
|
| Rate for Payer: Global Benefits Group Commercial |
$60.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.11
|
| Rate for Payer: Multiplan Commercial |
$94.28
|
| Rate for Payer: Multiplan Commercial |
$75.42
|
| Rate for Payer: Multiplan Commercial |
$94.27
|
| Rate for Payer: Networks By Design Commercial |
$50.28
|
| Rate for Payer: Networks By Design Commercial |
$62.84
|
| Rate for Payer: Networks By Design Commercial |
$62.85
|
| Rate for Payer: Prime Health Services Commercial |
$85.48
|
| Rate for Payer: Prime Health Services Commercial |
$106.84
|
| Rate for Payer: Prime Health Services Commercial |
$106.84
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
OP
|
$3.97
|
|
|
Service Code
|
NDC 0574-0106-03
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.35
|
| Rate for Payer: BCBS Transplant Transplant |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California EPN |
$1.94
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Central Health Plan Commercial |
$3.18
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$2.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.59
|
| Rate for Payer: Galaxy Health WC |
$3.37
|
| Rate for Payer: Global Benefits Group Commercial |
$2.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.98
|
| Rate for Payer: IEHP medi-cal |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Multiplan Commercial |
$2.98
|
| Rate for Payer: Networks By Design Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$3.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.38
|
| Rate for Payer: Riverside University Health MISP |
$1.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.98
|
| Rate for Payer: United Healthcare All Other HMO |
$1.98
|
| Rate for Payer: United Healthcare HMO Rider |
$1.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.37
|
| Rate for Payer: Vantage Medical Group Senior |
$3.37
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
IP
|
$6.02
|
|
|
Service Code
|
NDC 0781-5325-31
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$4.52
|
| Rate for Payer: Blue Shield of California EPN |
$3.21
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Central Health Plan Commercial |
$4.82
|
| Rate for Payer: Cigna of CA HMO |
$4.21
|
| Rate for Payer: Cigna of CA PPO |
$4.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.41
|
| Rate for Payer: Galaxy Health WC |
$5.12
|
| Rate for Payer: Global Benefits Group Commercial |
$3.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Multiplan Commercial |
$4.52
|
| Rate for Payer: Networks By Design Commercial |
$3.91
|
| Rate for Payer: Prime Health Services Commercial |
$5.12
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
OP
|
$3.97
|
|
|
Service Code
|
NDC 63304-962-30
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.35
|
| Rate for Payer: BCBS Transplant Transplant |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California EPN |
$1.94
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Central Health Plan Commercial |
$3.18
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$2.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.59
|
| Rate for Payer: Galaxy Health WC |
$3.37
|
| Rate for Payer: Global Benefits Group Commercial |
$2.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.98
|
| Rate for Payer: IEHP medi-cal |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Multiplan Commercial |
$2.98
|
| Rate for Payer: Networks By Design Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$3.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.38
|
| Rate for Payer: Riverside University Health MISP |
$1.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.98
|
| Rate for Payer: United Healthcare All Other HMO |
$1.98
|
| Rate for Payer: United Healthcare HMO Rider |
$1.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.37
|
| Rate for Payer: Vantage Medical Group Senior |
$3.37
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
IP
|
$3.97
|
|
|
Service Code
|
NDC 0574-0106-03
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2.98
|
| Rate for Payer: Blue Shield of California EPN |
$2.12
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Central Health Plan Commercial |
$3.18
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$2.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.59
|
| Rate for Payer: Galaxy Health WC |
$3.37
|
| Rate for Payer: Global Benefits Group Commercial |
$2.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Multiplan Commercial |
$2.98
|
| Rate for Payer: Networks By Design Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$3.37
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
IP
|
$3.97
|
|
|
Service Code
|
NDC 63304-962-30
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2.98
|
| Rate for Payer: Blue Shield of California EPN |
$2.12
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Central Health Plan Commercial |
$3.18
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$2.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.59
|
| Rate for Payer: Galaxy Health WC |
$3.37
|
| Rate for Payer: Global Benefits Group Commercial |
$2.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Multiplan Commercial |
$2.98
|
| Rate for Payer: Networks By Design Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$3.37
|
|
|
BROMOCRIPTINE 2.5 MG TABLET [9297]
|
Facility
OP
|
$6.02
|
|
|
Service Code
|
NDC 0781-5325-31
|
| Hospital Charge Code |
1710748
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.56
|
| Rate for Payer: BCBS Transplant Transplant |
$3.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3.79
|
| Rate for Payer: Blue Shield of California EPN |
$2.94
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Central Health Plan Commercial |
$4.82
|
| Rate for Payer: Cigna of CA HMO |
$4.21
|
| Rate for Payer: Cigna of CA PPO |
$4.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.41
|
| Rate for Payer: Galaxy Health WC |
$5.12
|
| Rate for Payer: Global Benefits Group Commercial |
$3.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.42
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.52
|
| Rate for Payer: IEHP medi-cal |
$2.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Multiplan Commercial |
$4.52
|
| Rate for Payer: Networks By Design Commercial |
$3.91
|
| Rate for Payer: Prime Health Services Commercial |
$5.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.61
|
| Rate for Payer: Riverside University Health MISP |
$2.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.01
|
| Rate for Payer: United Healthcare All Other HMO |
$3.01
|
| Rate for Payer: United Healthcare HMO Rider |
$3.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.12
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
BROMPHENIRAMINE-PHENYLEPHRINE 1 MG-2.5 MG/5 ML ORAL SOLUTION [77434]
|
Facility
IP
|
$0.02
|
|
|
Service Code
|
NDC 49348-777-34
|
| Hospital Charge Code |
NDG77434
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$0.02
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.02
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.02
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
|
BROMPHENIRAMINE-PHENYLEPHRINE 1 MG-2.5 MG/5 ML ORAL SOLUTION [77434]
|
Facility
OP
|
$0.02
|
|
|
Service Code
|
NDC 49348-777-34
|
| Hospital Charge Code |
NDG77434
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: BCBS Transplant Transplant |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.02
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.02
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.02
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: Riverside University Health MISP |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
| Rate for Payer: United Healthcare All Other HMO |
$0.01
|
| Rate for Payer: United Healthcare HMO Rider |
$0.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
|
BRONCHIOLITIS AND RSV PNEUMONIA
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1384
|
| Min. Negotiated Rate |
$13,943.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,943.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$16,616.46
|
|
|
BRONCHIOLITIS AND RSV PNEUMONIA
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1383
|
| Min. Negotiated Rate |
$6,559.19 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,559.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$7,816.37
|
|
|
BRONCHIOLITIS AND RSV PNEUMONIA
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1382
|
| Min. Negotiated Rate |
$4,140.94 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,140.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$4,934.62
|
|
|
BRONCHIOLITIS AND RSV PNEUMONIA
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1381
|
| Min. Negotiated Rate |
$2,890.93 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,890.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$3,445.03
|
|
|
BRONCHITIS AND ASTHMA AGE 0-17
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
TRIS-DRG 141
|
| Min. Negotiated Rate |
$34,005.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
|
|
BRONCHITIS AND ASTHMA AGE >17 WITH CC/MCC
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
TRIS-DRG 202
|
| Min. Negotiated Rate |
$34,005.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
|
|
BRONCHITIS AND ASTHMA AGE >17 WITHOUT CC/MCC
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
TRIS-DRG 203
|
| Min. Negotiated Rate |
$34,005.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)
|
Facility
OP
|
$7,027.00
|
|
|
Service Code
|
CPT 31622
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,120.62 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$3,499.02
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 31634
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,691.12
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$8,551.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: IEHP medi-cal |
$14,109.98
|
| Rate for Payer: IEHP Medicare Advantage |
$8,551.50
|
| Rate for Payer: Innovage PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Preferred Health Network WC |
$11,929.71
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Riverside University Health MISP |
$9,406.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage
|
Facility
OP
|
$7,027.00
|
|
|
Service Code
|
CPT 31624
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,120.62 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$3,499.02
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites
|
Facility
OP
|
$7,027.00
|
|
|
Service Code
|
CPT 31625
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,120.62 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$3,499.02
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s])
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 31627
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 31641
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 31653
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 31652
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 31640
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
