|
HC ABDOMEN/RETROPERIT PERC BIO
|
Facility
|
OP
|
$3,449.00
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
909000161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$689.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,369.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,896.95
|
| Rate for Payer: Cash Price |
$1,896.95
|
| Rate for Payer: Cash Price |
$1,896.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,241.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,134.93
|
| Rate for Payer: Heritage Provider Network Senior |
$2,532.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$404.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,911.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$624.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$862.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$2,586.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,264.55
|
| Rate for Payer: TriValley Medical Group Senior |
$2,264.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC ABDOMEN SINGLE AP VIEW
|
Facility
|
OP
|
$507.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
909001175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.85 |
| Max. Negotiated Rate |
$380.25 |
| Rate for Payer: Adventist Health Commercial |
$101.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$270.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$348.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.78
|
| Rate for Payer: Blue Shield of California Commercial |
$102.43
|
| Rate for Payer: Blue Shield of California EPN |
$82.37
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$329.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$329.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$313.83
|
| Rate for Payer: Heritage Provider Network Senior |
$313.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$241.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$380.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$99.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$99.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC ABDOMEN SINGLE AP VIEW
|
Facility
|
IP
|
$507.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
909001175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.77 |
| Max. Negotiated Rate |
$380.25 |
| Rate for Payer: Adventist Health Commercial |
$101.40
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$343.24
|
| Rate for Payer: Heritage Provider Network Senior |
$343.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.75
|
| Rate for Payer: Multiplan Commercial |
$380.25
|
|
|
HC ABDOMEN THREE OR MORE VIEWS
|
Facility
|
OP
|
$958.00
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
909074021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.59 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Adventist Health Commercial |
$191.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$512.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$658.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$251.38
|
| Rate for Payer: Blue Shield of California Commercial |
$142.85
|
| Rate for Payer: Blue Shield of California EPN |
$114.87
|
| Rate for Payer: Cash Price |
$526.90
|
| Rate for Payer: Cash Price |
$526.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$622.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$622.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$593.00
|
| Rate for Payer: Heritage Provider Network Senior |
$593.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$60.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$456.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$718.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$189.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$189.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC ABDOMEN THREE OR MORE VIEWS
|
Facility
|
IP
|
$958.00
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
909074021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$173.40 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Adventist Health Commercial |
$191.60
|
| Rate for Payer: Cash Price |
$526.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.57
|
| Rate for Payer: Heritage Provider Network Senior |
$648.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.50
|
| Rate for Payer: Multiplan Commercial |
$718.50
|
|
|
HC ABDOMEN TWO VIEWS
|
Facility
|
IP
|
$743.00
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
909074019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.48 |
| Max. Negotiated Rate |
$557.25 |
| Rate for Payer: Adventist Health Commercial |
$148.60
|
| Rate for Payer: Cash Price |
$408.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$503.01
|
| Rate for Payer: Heritage Provider Network Senior |
$503.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.75
|
| Rate for Payer: Multiplan Commercial |
$557.25
|
|
|
HC ABDOMEN TWO VIEWS
|
Facility
|
OP
|
$743.00
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
909074019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$48.70 |
| Max. Negotiated Rate |
$557.25 |
| Rate for Payer: Adventist Health Commercial |
$148.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$397.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$510.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$215.55
|
| Rate for Payer: Blue Shield of California Commercial |
$122.64
|
| Rate for Payer: Blue Shield of California EPN |
$98.62
|
| Rate for Payer: Cash Price |
$408.65
|
| Rate for Payer: Cash Price |
$408.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$482.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$459.92
|
| Rate for Payer: Heritage Provider Network Senior |
$459.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$354.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$557.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$189.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$189.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$981.17
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$902.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$448.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,263.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,310.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
OP
|
$1,957.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$391.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,344.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,193.77
|
| Rate for Payer: Blue Shield of California EPN |
$955.02
|
| Rate for Payer: Cash Price |
$1,076.35
|
| Rate for Payer: Cash Price |
$1,076.35
|
| Rate for Payer: Cash Price |
$1,076.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,272.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,211.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,211.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$448.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$933.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$354.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$1,467.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,191.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$978.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$978.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
IP
|
$1,957.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$354.22 |
| Max. Negotiated Rate |
$1,467.75 |
| Rate for Payer: Adventist Health Commercial |
$391.40
|
| Rate for Payer: Cash Price |
$1,076.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,324.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1,324.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$354.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.25
|
| Rate for Payer: Multiplan Commercial |
$1,467.75
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$94.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,263.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,310.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,982.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,875.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,786.43
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$94.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,263.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,310.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.37 |
| Max. Negotiated Rate |
$2,164.50 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,953.82
|
| Rate for Payer: Heritage Provider Network Senior |
$1,953.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,138.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$427.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,468.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,175.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,603.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,175.90
|
| Rate for Payer: Cash Price |
$1,175.90
|
| Rate for Payer: Cash Price |
$1,175.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,389.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,817.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,817.30
|
| Rate for Payer: Dignity Health Senior |
$1,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,323.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,323.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,019.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$386.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,496.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,496.60
|
| Rate for Payer: Multiplan Commercial |
$1,603.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,817.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,817.30
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.38 |
| Max. Negotiated Rate |
$1,650.75 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,490.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1,490.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$398.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$550.25
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
IP
|
$2,138.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$386.98 |
| Max. Negotiated Rate |
$1,603.50 |
| Rate for Payer: Adventist Health Commercial |
$427.60
|
| Rate for Payer: Cash Price |
$1,175.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,447.43
|
| Rate for Payer: Heritage Provider Network Senior |
$1,447.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$386.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.50
|
| Rate for Payer: Multiplan Commercial |
$1,603.50
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,512.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,210.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,650.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,430.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,870.85
|
| Rate for Payer: Dignity Health Senior |
$1,870.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,362.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,362.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,049.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$398.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$550.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,540.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,540.70
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,870.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,870.85
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
OP
|
$765.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
906820180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$153.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$525.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$650.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$420.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$573.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$420.75
|
| Rate for Payer: Cash Price |
$420.75
|
| Rate for Payer: Cash Price |
$420.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$497.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$650.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$650.25
|
| Rate for Payer: Dignity Health Senior |
$650.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$473.54
|
| Rate for Payer: Heritage Provider Network Senior |
$473.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$394.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$364.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$535.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$535.50
|
| Rate for Payer: Multiplan Commercial |
$573.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$650.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$650.25
|
| Rate for Payer: Vantage Medical Group Senior |
$650.25
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
IP
|
$765.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
906820180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.47 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Adventist Health Commercial |
$153.00
|
| Rate for Payer: Cash Price |
$420.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$517.90
|
| Rate for Payer: Heritage Provider Network Senior |
$517.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.25
|
| Rate for Payer: Multiplan Commercial |
$573.75
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
909081324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.45 |
| Max. Negotiated Rate |
$590.25 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.80
|
| Rate for Payer: Heritage Provider Network Senior |
$532.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
909081324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$540.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$432.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$590.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cash Price |
$432.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$511.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$668.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$668.95
|
| Rate for Payer: Dignity Health Senior |
$668.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$487.15
|
| Rate for Payer: Heritage Provider Network Senior |
$487.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$394.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$375.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$550.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$550.90
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$668.95
|
| Rate for Payer: Vantage Medical Group Senior |
$668.95
|
|
