|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
IP
|
$1,459.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$291.80 |
| Max. Negotiated Rate |
$1,313.10 |
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$583.60
|
| Rate for Payer: EPIC Health Plan Senior |
$583.60
|
| Rate for Payer: Galaxy Health WC |
$1,240.15
|
| Rate for Payer: Global Benefits Group Commercial |
$875.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$973.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$555.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.80
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| Rate for Payer: Networks By Design Commercial |
$948.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.15
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
OP
|
$1,459.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.20
|
| Rate for Payer: Cigna of CA HMO |
$933.76
|
| Rate for Payer: Cigna of CA PPO |
$1,079.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,240.15
|
| Rate for Payer: Global Benefits Group Commercial |
$875.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$973.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| Rate for Payer: Networks By Design Commercial |
$948.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
OP
|
$1,459.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$891.45
|
| Rate for Payer: Blue Shield of California EPN |
$582.14
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Cash Price |
$802.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.20
|
| Rate for Payer: Cigna of CA HMO |
$933.76
|
| Rate for Payer: Cigna of CA PPO |
$1,079.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,240.15
|
| Rate for Payer: Global Benefits Group Commercial |
$875.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$973.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| Rate for Payer: Networks By Design Commercial |
$948.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$875.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$729.50
|
| Rate for Payer: United Healthcare All Other HMO |
$729.50
|
| Rate for Payer: United Healthcare HMO Rider |
$729.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$729.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
IP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,039.00 |
| Max. Negotiated Rate |
$4,675.50 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,078.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,078.00
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,465.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,979.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,215.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
IP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,039.00 |
| Max. Negotiated Rate |
$4,675.50 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,078.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,078.00
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,465.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,979.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,215.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
OP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$165.53 |
| Max. Negotiated Rate |
$5,714.55 |
| Rate for Payer: Adventist Health Commercial |
$2,129.95
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,551.91
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Cigna of CA HMO |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,844.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,465.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,117.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,117.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
OP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.53 |
| Max. Negotiated Rate |
$5,714.55 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,551.91
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Cash Price |
$2,857.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Cigna of CA HMO |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,844.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,465.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,117.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,597.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,597.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,597.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,597.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC PROGESTERONE
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$151.78 |
| Rate for Payer: Adventist Health Commercial |
$21.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.80
|
| Rate for Payer: Blue Shield of California Commercial |
$64.34
|
| Rate for Payer: Blue Shield of California EPN |
$42.08
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: Cigna of CA HMO |
$67.84
|
| Rate for Payer: Cigna of CA PPO |
$78.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.16
|
| Rate for Payer: EPIC Health Plan Senior |
$20.86
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.86
|
| Rate for Payer: InnovAge PACE Commercial |
$31.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.95
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.86
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
| Rate for Payer: Prime Health Services Medicare |
$22.11
|
| Rate for Payer: Riverside University Health System MISP |
$22.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
|
|
HC PROGESTERONE
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Adventist Health Commercial |
$21.20
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: EPIC Health Plan Senior |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
|
|
HC PROLACTIN
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
900910808
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
|
|
HC PROLACTIN
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
900910808
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.70 |
| Max. Negotiated Rate |
$140.96 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.61
|
| Rate for Payer: Blue Shield of California Commercial |
$50.99
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.38
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.38
|
| Rate for Payer: InnovAge PACE Commercial |
$29.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.97
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.38
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$20.54
|
| Rate for Payer: Riverside University Health System MISP |
$21.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Vantage Medical Group Senior |
$19.38
|
|
|
HC PROPHYLAXIS OF RETINAL DETCHMNT
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 67141
|
| Hospital Charge Code |
900567141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.91 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$686.95
|
| Rate for Payer: Cash Price |
$686.95
|
| Rate for Payer: Cash Price |
$686.95
|
| Rate for Payer: Cash Price |
$686.95
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$569.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$417.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.76
|
| Rate for Payer: EPIC Health Plan Senior |
$379.82
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$622.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$379.82
|
| Rate for Payer: InnovAge PACE Commercial |
$569.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$379.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.96
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$379.82
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$402.61
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$417.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.50
|
| Rate for Payer: United Healthcare All Other HMO |
$624.50
|
| Rate for Payer: United Healthcare HMO Rider |
$624.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$379.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Vantage Medical Group Senior |
$379.82
|
|
|
HC PROPHYLAXIS OF RETINAL DETCHMNT
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 67141
|
| Hospital Charge Code |
900567141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$686.95
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$475.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC PROPORT CNTR 12 VOLT UTAH
|
Facility
|
OP
|
$18,471.00
|
|
|
Service Code
|
CPT L7274
|
| Hospital Charge Code |
905357274
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,049.25 |
| Max. Negotiated Rate |
$16,623.90 |
| Rate for Payer: Adventist Health Commercial |
$7,573.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,700.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,159.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,853.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,848.02
|
| Rate for Payer: Blue Shield of California Commercial |
$14,278.08
|
| Rate for Payer: Blue Shield of California EPN |
$9,309.38
|
| Rate for Payer: Cash Price |
$10,159.05
|
| Rate for Payer: Central Health Plan Commercial |
$14,776.80
|
| Rate for Payer: Cigna of CA HMO |
$12,929.70
|
| Rate for Payer: Cigna of CA PPO |
$12,929.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,700.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,700.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,700.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,388.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7,388.40
|
| Rate for Payer: Galaxy Health WC |
$15,700.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11,082.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,623.90
|
| Rate for Payer: InnovAge PACE Commercial |
$9,235.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,320.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,037.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,433.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,573.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,929.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,929.70
|
| Rate for Payer: Multiplan Commercial |
$13,853.25
|
| Rate for Payer: Networks By Design Commercial |
$9,235.50
|
| Rate for Payer: Prime Health Services Commercial |
$15,700.35
|
| Rate for Payer: Riverside University Health System MISP |
$7,388.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,082.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,082.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,932.17
|
| Rate for Payer: United Healthcare All Other HMO |
$6,747.46
|
| Rate for Payer: United Healthcare HMO Rider |
$6,601.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,049.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,700.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,700.35
|
| Rate for Payer: Vantage Medical Group Senior |
$15,700.35
|
|
|
HC PROPORT CNTR 12 VOLT UTAH
|
Facility
|
IP
|
$18,471.00
|
|
|
Service Code
|
CPT L7274
|
| Hospital Charge Code |
905357274
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,694.20 |
| Max. Negotiated Rate |
$16,623.90 |
| Rate for Payer: Adventist Health Commercial |
$3,694.20
|
| Rate for Payer: Blue Shield of California Commercial |
$14,278.08
|
| Rate for Payer: Blue Shield of California EPN |
$9,309.38
|
| Rate for Payer: Cash Price |
$10,159.05
|
| Rate for Payer: Central Health Plan Commercial |
$14,776.80
|
| Rate for Payer: Cigna of CA HMO |
$12,929.70
|
| Rate for Payer: Cigna of CA PPO |
$12,929.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,388.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7,388.40
|
| Rate for Payer: Galaxy Health WC |
$15,700.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11,082.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,623.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,320.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,037.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,433.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,694.20
|
| Rate for Payer: Multiplan Commercial |
$13,853.25
|
| Rate for Payer: Networks By Design Commercial |
$12,006.15
|
| Rate for Payer: Prime Health Services Commercial |
$15,700.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,932.17
|
| Rate for Payer: United Healthcare All Other HMO |
$6,747.46
|
| Rate for Payer: United Healthcare HMO Rider |
$6,601.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,049.25
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
IP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
915355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$406.80 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,572.28
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,356.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$774.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,259.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
IP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
905355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$406.80 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,572.28
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,356.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$774.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,259.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
OP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
905355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$581.45 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$833.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,118.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,525.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,194.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,572.28
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,728.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,728.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$581.45
|
| Rate for Payer: InnovAge PACE Commercial |
$1,017.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,356.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$642.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,259.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,423.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,423.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: Riverside University Health System MISP |
$813.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,728.90
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
OP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
915355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$581.45 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$833.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,118.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,525.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,194.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,572.28
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Cash Price |
$1,118.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,728.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,728.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$581.45
|
| Rate for Payer: InnovAge PACE Commercial |
$1,017.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,356.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$642.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,259.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,423.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,423.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: Riverside University Health System MISP |
$813.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,728.90
|
|
|
HC PROS ADD EXO AXIAL ROTAT UNIT
|
Facility
|
OP
|
$1,353.00
|
|
|
Service Code
|
CPT L5982
|
| Hospital Charge Code |
905355982
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.11 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Adventist Health Commercial |
$554.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$744.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,014.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$794.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,045.87
|
| Rate for Payer: Blue Shield of California EPN |
$681.91
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,082.40
|
| Rate for Payer: Cigna of CA HMO |
$947.10
|
| Rate for Payer: Cigna of CA PPO |
$947.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,150.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,150.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$541.20
|
| Rate for Payer: Galaxy Health WC |
$1,150.05
|
| Rate for Payer: Global Benefits Group Commercial |
$811.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,217.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.05
|
| Rate for Payer: InnovAge PACE Commercial |
$676.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$902.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$730.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$837.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$554.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$947.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$947.10
|
| Rate for Payer: Multiplan Commercial |
$1,014.75
|
| Rate for Payer: Networks By Design Commercial |
$676.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,150.05
|
| Rate for Payer: Riverside University Health System MISP |
$541.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$811.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$811.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$507.78
|
| Rate for Payer: United Healthcare All Other HMO |
$494.25
|
| Rate for Payer: United Healthcare HMO Rider |
$483.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$443.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,150.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,150.05
|
|
|
HC PROS ADD EXO AXIAL ROTAT UNIT
|
Facility
|
IP
|
$1,353.00
|
|
|
Service Code
|
CPT L5982
|
| Hospital Charge Code |
915355982
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$270.60 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Adventist Health Commercial |
$270.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,045.87
|
| Rate for Payer: Blue Shield of California EPN |
$681.91
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,082.40
|
| Rate for Payer: Cigna of CA HMO |
$947.10
|
| Rate for Payer: Cigna of CA PPO |
$947.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$541.20
|
| Rate for Payer: Galaxy Health WC |
$1,150.05
|
| Rate for Payer: Global Benefits Group Commercial |
$811.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,217.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$902.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$515.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$837.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.60
|
| Rate for Payer: Multiplan Commercial |
$1,014.75
|
| Rate for Payer: Networks By Design Commercial |
$879.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,150.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$507.78
|
| Rate for Payer: United Healthcare All Other HMO |
$494.25
|
| Rate for Payer: United Healthcare HMO Rider |
$483.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$443.11
|
|
|
HC PROS ADD EXO AXIAL ROTAT UNIT
|
Facility
|
IP
|
$1,353.00
|
|
|
Service Code
|
CPT L5982
|
| Hospital Charge Code |
905355982
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$270.60 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Adventist Health Commercial |
$270.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,045.87
|
| Rate for Payer: Blue Shield of California EPN |
$681.91
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,082.40
|
| Rate for Payer: Cigna of CA HMO |
$947.10
|
| Rate for Payer: Cigna of CA PPO |
$947.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$541.20
|
| Rate for Payer: Galaxy Health WC |
$1,150.05
|
| Rate for Payer: Global Benefits Group Commercial |
$811.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,217.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$902.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$515.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$837.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.60
|
| Rate for Payer: Multiplan Commercial |
$1,014.75
|
| Rate for Payer: Networks By Design Commercial |
$879.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,150.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$507.78
|
| Rate for Payer: United Healthcare All Other HMO |
$494.25
|
| Rate for Payer: United Healthcare HMO Rider |
$483.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$443.11
|
|
|
HC PROS ADD EXO AXIAL ROTAT UNIT
|
Facility
|
OP
|
$1,353.00
|
|
|
Service Code
|
CPT L5982
|
| Hospital Charge Code |
915355982
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.11 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Adventist Health Commercial |
$554.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$744.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,014.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$794.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,045.87
|
| Rate for Payer: Blue Shield of California EPN |
$681.91
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Cash Price |
$744.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,082.40
|
| Rate for Payer: Cigna of CA HMO |
$947.10
|
| Rate for Payer: Cigna of CA PPO |
$947.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,150.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,150.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$541.20
|
| Rate for Payer: Galaxy Health WC |
$1,150.05
|
| Rate for Payer: Global Benefits Group Commercial |
$811.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,217.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.05
|
| Rate for Payer: InnovAge PACE Commercial |
$676.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$902.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$730.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$837.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$554.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$947.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$947.10
|
| Rate for Payer: Multiplan Commercial |
$1,014.75
|
| Rate for Payer: Networks By Design Commercial |
$676.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,150.05
|
| Rate for Payer: Riverside University Health System MISP |
$541.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$811.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$811.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$507.78
|
| Rate for Payer: United Healthcare All Other HMO |
$494.25
|
| Rate for Payer: United Healthcare HMO Rider |
$483.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$443.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,150.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,150.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,150.05
|
|
|
HC PROS ADDIT MCP ROTATION UNIT
|
Facility
|
OP
|
$2,316.00
|
|
|
Service Code
|
CPT L5986
|
| Hospital Charge Code |
905355986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$646.77 |
| Max. Negotiated Rate |
$2,084.40 |
| Rate for Payer: Adventist Health Commercial |
$949.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,968.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,273.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,737.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,360.19
|
| Rate for Payer: Blue Shield of California Commercial |
$1,790.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,167.26
|
| Rate for Payer: Cash Price |
$1,273.80
|
| Rate for Payer: Cash Price |
$1,273.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,852.80
|
| Rate for Payer: Cigna of CA HMO |
$1,621.20
|
| Rate for Payer: Cigna of CA PPO |
$1,621.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,968.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,968.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,968.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$926.40
|
| Rate for Payer: EPIC Health Plan Senior |
$926.40
|
| Rate for Payer: Galaxy Health WC |
$1,968.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,389.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,084.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$646.77
|
| Rate for Payer: InnovAge PACE Commercial |
$1,158.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,544.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$714.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,433.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,621.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,621.20
|
| Rate for Payer: Multiplan Commercial |
$1,737.00
|
| Rate for Payer: Networks By Design Commercial |
$1,158.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,968.60
|
| Rate for Payer: Riverside University Health System MISP |
$926.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,389.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,389.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$869.19
|
| Rate for Payer: United Healthcare All Other HMO |
$846.03
|
| Rate for Payer: United Healthcare HMO Rider |
$827.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$758.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,968.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,968.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,968.60
|
|
|
HC PROS ADDIT MCP ROTATION UNIT
|
Facility
|
IP
|
$2,316.00
|
|
|
Service Code
|
CPT L5986
|
| Hospital Charge Code |
915355986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$463.20 |
| Max. Negotiated Rate |
$2,084.40 |
| Rate for Payer: Adventist Health Commercial |
$463.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,790.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,167.26
|
| Rate for Payer: Cash Price |
$1,273.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,852.80
|
| Rate for Payer: Cigna of CA HMO |
$1,621.20
|
| Rate for Payer: Cigna of CA PPO |
$1,621.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$926.40
|
| Rate for Payer: EPIC Health Plan Senior |
$926.40
|
| Rate for Payer: Galaxy Health WC |
$1,968.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,389.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,084.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,544.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$882.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,433.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$463.20
|
| Rate for Payer: Multiplan Commercial |
$1,737.00
|
| Rate for Payer: Networks By Design Commercial |
$1,505.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,968.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$869.19
|
| Rate for Payer: United Healthcare All Other HMO |
$846.03
|
| Rate for Payer: United Healthcare HMO Rider |
$827.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$758.49
|
|
