|
HC ROOM MED SURG ACUTE NONE 1:4
|
Facility
|
IP
|
$4,757.00
|
|
| Hospital Charge Code |
992312005
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$951.40 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$951.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,805.60
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,902.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,902.80
|
| Rate for Payer: Galaxy Health WC |
$4,043.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,854.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,281.30
|
| Rate for Payer: Health Net Behavioral |
$1,500.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,172.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,812.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,944.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$951.40
|
| Rate for Payer: Multiplan Commercial |
$3,567.75
|
| Rate for Payer: Networks By Design Commercial |
$3,092.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,043.45
|
|
|
HC ROOM MED SURG ACUTE NONE 1:4
|
Facility
|
IP
|
$4,757.00
|
|
| Hospital Charge Code |
992313005
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$951.40 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$951.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Cash Price |
$2,616.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,805.60
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,902.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,902.80
|
| Rate for Payer: Galaxy Health WC |
$4,043.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,854.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,281.30
|
| Rate for Payer: Health Net Behavioral |
$1,500.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,172.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,812.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,944.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$951.40
|
| Rate for Payer: Multiplan Commercial |
$3,567.75
|
| Rate for Payer: Networks By Design Commercial |
$3,092.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,043.45
|
|
|
HC ROOM NICU II CONTINUING CARE
|
Facility
|
IP
|
$11,886.00
|
|
| Hospital Charge Code |
902300022
|
|
Hospital Revenue Code
|
172
|
| Min. Negotiated Rate |
$2,377.20 |
| Max. Negotiated Rate |
$13,860.00 |
| Rate for Payer: Adventist Health Commercial |
$2,377.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$6,537.30
|
| Rate for Payer: Cash Price |
$6,537.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,508.80
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,754.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,754.40
|
| Rate for Payer: Galaxy Health WC |
$10,103.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,131.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,697.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,927.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,528.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,357.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,377.20
|
| Rate for Payer: Multiplan Commercial |
$8,914.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,103.10
|
|
|
HC ROOM NICU II CONTINUING CARE ISOLATION
|
Facility
|
IP
|
$15,860.00
|
|
| Hospital Charge Code |
902300023
|
|
Hospital Revenue Code
|
172
|
| Min. Negotiated Rate |
$3,172.00 |
| Max. Negotiated Rate |
$14,274.00 |
| Rate for Payer: Adventist Health Commercial |
$3,172.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$8,723.00
|
| Rate for Payer: Cash Price |
$8,723.00
|
| Rate for Payer: Central Health Plan Commercial |
$12,688.00
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,344.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,344.00
|
| Rate for Payer: Galaxy Health WC |
$13,481.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9,516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,274.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,578.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,042.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,817.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,172.00
|
| Rate for Payer: Multiplan Commercial |
$11,895.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,481.00
|
|
|
HC ROOM NICU III INTERMEDIATE
|
Facility
|
IP
|
$21,667.00
|
|
| Hospital Charge Code |
902300024
|
|
Hospital Revenue Code
|
173
|
| Min. Negotiated Rate |
$4,333.40 |
| Max. Negotiated Rate |
$19,500.30 |
| Rate for Payer: Adventist Health Commercial |
$4,333.40
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$11,916.85
|
| Rate for Payer: Cash Price |
$11,916.85
|
| Rate for Payer: Central Health Plan Commercial |
$17,333.60
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,666.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,666.80
|
| Rate for Payer: Galaxy Health WC |
$18,416.95
|
| Rate for Payer: Global Benefits Group Commercial |
$13,000.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,500.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,451.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,411.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,333.40
|
| Rate for Payer: Multiplan Commercial |
$16,250.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,416.95
|
|
|
HC ROOM NICU III INTERMEDIATE ISOLATION
|
Facility
|
IP
|
$22,996.00
|
|
| Hospital Charge Code |
902300025
|
|
Hospital Revenue Code
|
173
|
| Min. Negotiated Rate |
$4,599.20 |
| Max. Negotiated Rate |
$20,696.40 |
| Rate for Payer: Adventist Health Commercial |
$4,599.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$12,647.80
|
| Rate for Payer: Cash Price |
$12,647.80
|
| Rate for Payer: Central Health Plan Commercial |
$18,396.80
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,198.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,198.40
|
| Rate for Payer: Galaxy Health WC |
$19,546.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13,797.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,696.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,338.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,761.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,234.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,599.20
|
| Rate for Payer: Multiplan Commercial |
$17,247.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,546.60
|
|
|
HC ROOM NICU IV INTENSIVE
|
Facility
|
IP
|
$25,734.00
|
|
| Hospital Charge Code |
902300026
|
|
Hospital Revenue Code
|
174
|
| Min. Negotiated Rate |
$5,146.80 |
| Max. Negotiated Rate |
$23,160.60 |
| Rate for Payer: Adventist Health Commercial |
$5,146.80
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$14,153.70
|
| Rate for Payer: Cash Price |
$14,153.70
|
| Rate for Payer: Central Health Plan Commercial |
$20,587.20
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,293.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,293.60
|
| Rate for Payer: Galaxy Health WC |
$21,873.90
|
| Rate for Payer: Global Benefits Group Commercial |
$15,440.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,160.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,164.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,804.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,929.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,146.80
|
| Rate for Payer: Multiplan Commercial |
$19,300.50
|
| Rate for Payer: Prime Health Services Commercial |
$21,873.90
|
|
|
HC ROOM NICU IV INTENSIVE ISOLATION
|
Facility
|
IP
|
$29,751.00
|
|
| Hospital Charge Code |
902300027
|
|
Hospital Revenue Code
|
174
|
| Min. Negotiated Rate |
$5,850.00 |
| Max. Negotiated Rate |
$26,775.90 |
| Rate for Payer: Adventist Health Commercial |
$5,950.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$16,363.05
|
| Rate for Payer: Cash Price |
$16,363.05
|
| Rate for Payer: Central Health Plan Commercial |
$23,800.80
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,900.40
|
| Rate for Payer: EPIC Health Plan Senior |
$11,900.40
|
| Rate for Payer: Galaxy Health WC |
$25,288.35
|
| Rate for Payer: Global Benefits Group Commercial |
$17,850.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,775.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,843.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,335.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,415.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,950.20
|
| Rate for Payer: Multiplan Commercial |
$22,313.25
|
| Rate for Payer: Prime Health Services Commercial |
$25,288.35
|
|
|
HC ROOM NICU IV INTENSIVE ISOLATION 1:1
|
Facility
|
IP
|
$27,044.00
|
|
| Hospital Charge Code |
992300027
|
|
Hospital Revenue Code
|
174
|
| Min. Negotiated Rate |
$5,408.80 |
| Max. Negotiated Rate |
$24,339.60 |
| Rate for Payer: Adventist Health Commercial |
$5,408.80
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$14,874.20
|
| Rate for Payer: Cash Price |
$14,874.20
|
| Rate for Payer: Central Health Plan Commercial |
$21,635.20
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,817.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,817.60
|
| Rate for Payer: Galaxy Health WC |
$22,987.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,226.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,339.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,038.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,303.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,740.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,408.80
|
| Rate for Payer: Multiplan Commercial |
$20,283.00
|
| Rate for Payer: Prime Health Services Commercial |
$22,987.40
|
|
|
HC ROOM NON HEART TRANSPLANT ISO
|
Facility
|
IP
|
$43,493.00
|
|
| Hospital Charge Code |
902358427
|
|
Hospital Revenue Code
|
209
|
| Min. Negotiated Rate |
$4,650.00 |
| Max. Negotiated Rate |
$39,143.70 |
| Rate for Payer: Adventist Health Commercial |
$8,698.60
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$23,921.15
|
| Rate for Payer: Cash Price |
$23,921.15
|
| Rate for Payer: Cash Price |
$23,921.15
|
| Rate for Payer: Central Health Plan Commercial |
$34,794.40
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,397.20
|
| Rate for Payer: EPIC Health Plan Senior |
$17,397.20
|
| Rate for Payer: Galaxy Health WC |
$36,969.05
|
| Rate for Payer: Global Benefits Group Commercial |
$26,095.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,143.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,009.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,570.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,922.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,698.60
|
| Rate for Payer: Multiplan Commercial |
$32,619.75
|
| Rate for Payer: Prime Health Services Commercial |
$36,969.05
|
|
|
HC ROOM NON HEART TX
|
Facility
|
IP
|
$34,325.00
|
|
| Hospital Charge Code |
902341258
|
|
Hospital Revenue Code
|
209
|
| Min. Negotiated Rate |
$4,650.00 |
| Max. Negotiated Rate |
$30,892.50 |
| Rate for Payer: Adventist Health Commercial |
$6,865.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Central Health Plan Commercial |
$27,460.00
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$13,730.00
|
| Rate for Payer: Galaxy Health WC |
$29,176.25
|
| Rate for Payer: Global Benefits Group Commercial |
$20,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,892.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,894.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,077.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,247.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,865.00
|
| Rate for Payer: Multiplan Commercial |
$25,743.75
|
| Rate for Payer: Prime Health Services Commercial |
$29,176.25
|
|
|
HC ROOM NON HEART TX 1:1
|
Facility
|
IP
|
$34,325.00
|
|
| Hospital Charge Code |
992341258
|
|
Hospital Revenue Code
|
209
|
| Min. Negotiated Rate |
$4,650.00 |
| Max. Negotiated Rate |
$30,892.50 |
| Rate for Payer: Adventist Health Commercial |
$6,865.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,860.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,086.00
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Cash Price |
$18,878.75
|
| Rate for Payer: Central Health Plan Commercial |
$27,460.00
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$13,730.00
|
| Rate for Payer: Galaxy Health WC |
$29,176.25
|
| Rate for Payer: Global Benefits Group Commercial |
$20,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,892.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,894.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,077.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,247.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,865.00
|
| Rate for Payer: Multiplan Commercial |
$25,743.75
|
| Rate for Payer: Prime Health Services Commercial |
$29,176.25
|
|
|
HC ROOM NURSERY
|
Facility
|
IP
|
$2,787.00
|
|
| Hospital Charge Code |
902300020
|
|
Hospital Revenue Code
|
170
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,893.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,242.00
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$945.00
|
| Rate for Payer: Cigna of CA PPO |
$1,155.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC ROOM OB
|
Facility
|
IP
|
$6,194.00
|
|
| Hospital Charge Code |
902300003
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,238.80 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,238.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,032.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,610.00
|
| Rate for Payer: Cash Price |
$3,406.70
|
| Rate for Payer: Cash Price |
$3,406.70
|
| Rate for Payer: Cash Price |
$3,406.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,955.20
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,477.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,477.60
|
| Rate for Payer: Galaxy Health WC |
$5,264.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,716.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,574.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,131.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,359.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,834.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,238.80
|
| Rate for Payer: Multiplan Commercial |
$4,645.50
|
| Rate for Payer: Networks By Design Commercial |
$4,026.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,264.90
|
|
|
HC ROOM OB HIGH RISK
|
Facility
|
IP
|
$7,731.00
|
|
| Hospital Charge Code |
902300004
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,546.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,546.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,032.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,610.00
|
| Rate for Payer: Cash Price |
$4,252.05
|
| Rate for Payer: Cash Price |
$4,252.05
|
| Rate for Payer: Cash Price |
$4,252.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,184.80
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,092.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,092.40
|
| Rate for Payer: Galaxy Health WC |
$6,571.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,638.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,957.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,156.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,945.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,546.20
|
| Rate for Payer: Multiplan Commercial |
$5,798.25
|
| Rate for Payer: Networks By Design Commercial |
$5,025.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,571.35
|
|
|
HC ROOM OB HIGH RISK ISOLATION
|
Facility
|
IP
|
$9,203.00
|
|
| Hospital Charge Code |
902300012
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,840.60 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,840.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$5,061.65
|
| Rate for Payer: Cash Price |
$5,061.65
|
| Rate for Payer: Cash Price |
$5,061.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,362.40
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,681.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,681.20
|
| Rate for Payer: Galaxy Health WC |
$7,822.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,521.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,282.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,138.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,506.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,696.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,840.60
|
| Rate for Payer: Multiplan Commercial |
$6,902.25
|
| Rate for Payer: Networks By Design Commercial |
$5,981.95
|
| Rate for Payer: Prime Health Services Commercial |
$7,822.55
|
|
|
HC ROOM OB ISOLATION
|
Facility
|
IP
|
$6,946.00
|
|
| Hospital Charge Code |
902300013
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,389.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,389.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$3,820.30
|
| Rate for Payer: Cash Price |
$3,820.30
|
| Rate for Payer: Cash Price |
$3,820.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,556.80
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,778.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,778.40
|
| Rate for Payer: Galaxy Health WC |
$5,904.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,167.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,251.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,646.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,299.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,389.20
|
| Rate for Payer: Multiplan Commercial |
$5,209.50
|
| Rate for Payer: Networks By Design Commercial |
$4,514.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,904.10
|
|
|
HC ROOM OBSERVATION
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
902350001
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$9,601.00 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,772.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$228.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$201.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,981.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,789.00
|
| Rate for Payer: Blue Shield of California Commercial |
$164.36
|
| Rate for Payer: Blue Shield of California EPN |
$107.33
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: Cigna of CA HMO |
$172.16
|
| Rate for Payer: Cigna of CA PPO |
$199.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$228.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$228.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.60
|
| Rate for Payer: EPIC Health Plan Senior |
$107.60
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: InnovAge PACE Commercial |
$134.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$166.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.30
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
| Rate for Payer: Riverside University Health System MISP |
$107.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,601.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,518.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$228.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$228.65
|
| Rate for Payer: Vantage Medical Group Senior |
$228.65
|
|
|
HC ROOM OBSERVATION
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
902350001
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.60
|
| Rate for Payer: EPIC Health Plan Senior |
$107.60
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$166.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
|
|
HC ROOM OB TRAUMA
|
Facility
|
IP
|
$5,953.00
|
|
| Hospital Charge Code |
902300005
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,190.60 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,190.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,032.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,610.00
|
| Rate for Payer: Cash Price |
$3,274.15
|
| Rate for Payer: Cash Price |
$3,274.15
|
| Rate for Payer: Cash Price |
$3,274.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,762.40
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,381.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,381.20
|
| Rate for Payer: Galaxy Health WC |
$5,060.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,571.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,357.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,970.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,268.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,684.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,190.60
|
| Rate for Payer: Multiplan Commercial |
$4,464.75
|
| Rate for Payer: Networks By Design Commercial |
$3,869.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,060.05
|
|
|
HC ROOM OB TRAUMA ISO
|
Facility
|
IP
|
$7,713.00
|
|
| Hospital Charge Code |
902300014
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,542.60 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,542.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$4,242.15
|
| Rate for Payer: Cash Price |
$4,242.15
|
| Rate for Payer: Cash Price |
$4,242.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,170.40
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,085.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,085.20
|
| Rate for Payer: Galaxy Health WC |
$6,556.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,627.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,941.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,144.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,938.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,774.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,542.60
|
| Rate for Payer: Multiplan Commercial |
$5,784.75
|
| Rate for Payer: Networks By Design Commercial |
$5,013.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,556.05
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
IP
|
$119.00
|
|
|
Service Code
|
CPT 99220
|
| Hospital Charge Code |
902350000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$65.45
|
| Rate for Payer: Central Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.60
|
| Rate for Payer: EPIC Health Plan Senior |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$101.15
|
| Rate for Payer: Global Benefits Group Commercial |
$71.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.80
|
| Rate for Payer: Multiplan Commercial |
$89.25
|
| Rate for Payer: Networks By Design Commercial |
$77.35
|
| Rate for Payer: Prime Health Services Commercial |
$101.15
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
IP
|
$137.00
|
|
|
Service Code
|
CPT 99236
|
| Hospital Charge Code |
902360000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Adventist Health Commercial |
$27.40
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: EPIC Health Plan Senior |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
CPT 99220
|
| Hospital Charge Code |
902350000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$89.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.89
|
| Rate for Payer: Blue Shield of California Commercial |
$72.71
|
| Rate for Payer: Blue Shield of California EPN |
$47.48
|
| Rate for Payer: Cash Price |
$65.45
|
| Rate for Payer: Central Health Plan Commercial |
$95.20
|
| Rate for Payer: Cigna of CA HMO |
$76.16
|
| Rate for Payer: Cigna of CA PPO |
$88.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$101.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.60
|
| Rate for Payer: EPIC Health Plan Senior |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$101.15
|
| Rate for Payer: Global Benefits Group Commercial |
$71.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.10
|
| Rate for Payer: InnovAge PACE Commercial |
$59.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.30
|
| Rate for Payer: Multiplan Commercial |
$89.25
|
| Rate for Payer: Networks By Design Commercial |
$77.35
|
| Rate for Payer: Prime Health Services Commercial |
$101.15
|
| Rate for Payer: Riverside University Health System MISP |
$47.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.50
|
| Rate for Payer: United Healthcare All Other HMO |
$59.50
|
| Rate for Payer: United Healthcare HMO Rider |
$59.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.15
|
| Rate for Payer: Vantage Medical Group Senior |
$101.15
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
OP
|
$137.00
|
|
|
Service Code
|
CPT 99236
|
| Hospital Charge Code |
902360000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$236.74 |
| Rate for Payer: Adventist Health Commercial |
$27.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.46
|
| Rate for Payer: Blue Shield of California Commercial |
$83.71
|
| Rate for Payer: Blue Shield of California EPN |
$54.66
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$87.68
|
| Rate for Payer: Cigna of CA PPO |
$101.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: EPIC Health Plan Senior |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$214.31
|
| Rate for Payer: InnovAge PACE Commercial |
$68.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.90
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: Riverside University Health System MISP |
$54.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.50
|
| Rate for Payer: United Healthcare All Other HMO |
$68.50
|
| Rate for Payer: United Healthcare HMO Rider |
$68.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.45
|
| Rate for Payer: Vantage Medical Group Senior |
$116.45
|
|
