|
HC ACUTE HEPATITIS PANEL
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
900910701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$383.27 |
| Rate for Payer: Adventist Health Commercial |
$33.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$89.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$115.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.21
|
| Rate for Payer: Blue Shield of California Commercial |
$383.27
|
| Rate for Payer: Blue Shield of California EPN |
$307.41
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$109.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.39
|
| Rate for Payer: Dignity Health Senior |
$47.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$47.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$103.99
|
| Rate for Payer: Heritage Provider Network Senior |
$103.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.01
|
| Rate for Payer: Multiplan Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$47.63
|
| Rate for Payer: TriValley Medical Group Senior |
$47.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$51.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$51.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.39
|
| Rate for Payer: Vantage Medical Group Senior |
$47.63
|
|
|
HC ACUTE HEPATITIS PANEL
|
Facility
|
IP
|
$867.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
900910701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$156.93 |
| Max. Negotiated Rate |
$650.25 |
| Rate for Payer: Adventist Health Commercial |
$173.40
|
| Rate for Payer: Cash Price |
$390.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$586.96
|
| Rate for Payer: Heritage Provider Network Senior |
$586.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.75
|
| Rate for Payer: Multiplan Commercial |
$650.25
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
905601756
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$140.14
|
| Rate for Payer: Heritage Provider Network Senior |
$140.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
905601756
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA Gatekeeper |
$110.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$142.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$134.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Senior |
$175.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$134.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$128.13
|
| Rate for Payer: Heritage Provider Network Senior |
$128.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$98.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$144.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE MCAL
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$140.14
|
| Rate for Payer: Heritage Provider Network Senior |
$140.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
|
|
HC ADAPTION/TRAIN SPEECH DEVICE MCAL
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA Gatekeeper |
$110.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$142.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$134.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Senior |
$175.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$134.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$128.13
|
| Rate for Payer: Heritage Provider Network Senior |
$128.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$98.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$144.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC ADDITIONAL FROZEN SECTIONS
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.15
|
| Rate for Payer: Blue Shield of California Commercial |
$51.36
|
| Rate for Payer: Blue Shield of California EPN |
$41.30
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$58.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$76.50
|
| Rate for Payer: Dignity Health Senior |
$76.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.71
|
| Rate for Payer: Heritage Provider Network Senior |
$55.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$42.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.50
|
| Rate for Payer: Vantage Medical Group Senior |
$76.50
|
|
|
HC ADDITIONAL FROZEN SECTIONS
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.78 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Adventist Health Commercial |
$76.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$257.26
|
| Rate for Payer: Heritage Provider Network Senior |
$257.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.00
|
| Rate for Payer: Multiplan Commercial |
$285.00
|
|
|
HC ADDL PMP NW SUBC THER INF SITE
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 96371
|
| Hospital Charge Code |
907296371
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$206.25 |
| Rate for Payer: Adventist Health Commercial |
$55.00
|
| Rate for Payer: Cash Price |
$123.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.18
|
| Rate for Payer: Heritage Provider Network Senior |
$186.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.75
|
| Rate for Payer: Multiplan Commercial |
$206.25
|
|
|
HC ADDL PMP NW SUBC THER INF SITE
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 96371
|
| Hospital Charge Code |
907296371
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$638.00 |
| Rate for Payer: Adventist Health Commercial |
$55.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$146.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$188.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.00
|
| Rate for Payer: Blue Shield of California Commercial |
$638.00
|
| Rate for Payer: Blue Shield of California EPN |
$512.00
|
| Rate for Payer: Cash Price |
$123.75
|
| Rate for Payer: Cash Price |
$123.75
|
| Rate for Payer: Cash Price |
$123.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$178.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Senior |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$90.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$170.22
|
| Rate for Payer: Heritage Provider Network Senior |
$170.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$109.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113.94
|
| Rate for Payer: Multiplan Commercial |
$206.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$99.47
|
| Rate for Payer: TriValley Medical Group Senior |
$90.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$626.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$526.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC ADD VENOUS ABLATION SNGL EXTRE
|
Facility
|
IP
|
$14,481.00
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
909080042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,621.06 |
| Max. Negotiated Rate |
$10,860.75 |
| Rate for Payer: Adventist Health Commercial |
$2,896.20
|
| Rate for Payer: Cash Price |
$6,516.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,803.64
|
| Rate for Payer: Heritage Provider Network Senior |
$9,803.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,621.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,620.25
|
| Rate for Payer: Multiplan Commercial |
$10,860.75
|
|
|
HC ADD VENOUS ABLATION SNGL EXTRE
|
Facility
|
OP
|
$14,481.00
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
909080042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$12,308.85 |
| Rate for Payer: Adventist Health Commercial |
$2,896.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,948.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,308.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,964.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,860.75
|
| 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 |
$6,516.45
|
| Rate for Payer: Cash Price |
$6,516.45
|
| Rate for Payer: Cash Price |
$6,516.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,412.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,308.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,308.85
|
| Rate for Payer: Dignity Health Senior |
$12,308.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,963.74
|
| Rate for Payer: Heritage Provider Network Senior |
$8,963.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$123.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,907.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,621.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,620.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,136.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,136.70
|
| Rate for Payer: Multiplan Commercial |
$10,860.75
|
| 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 |
$12,308.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,308.85
|
| Rate for Payer: Vantage Medical Group Senior |
$12,308.85
|
|
|
HC ADENOVIRUS DNA DETECTION BY PCR
|
Facility
|
OP
|
$363.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900913627
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$72.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$194.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$249.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$163.35
|
| Rate for Payer: Cash Price |
$163.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$235.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$224.70
|
| Rate for Payer: Heritage Provider Network Senior |
$224.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$173.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$272.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC ADENOVIRUS DNA DETECTION BY PCR
|
Facility
|
IP
|
$363.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900913627
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.70 |
| Max. Negotiated Rate |
$272.25 |
| Rate for Payer: Adventist Health Commercial |
$72.60
|
| Rate for Payer: Cash Price |
$163.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$245.75
|
| Rate for Payer: Heritage Provider Network Senior |
$245.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.75
|
| Rate for Payer: Multiplan Commercial |
$272.25
|
|
|
HC ADENOVIRUS DNA QUANT
|
Facility
|
IP
|
$332.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900913624
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$60.09 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Adventist Health Commercial |
$66.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$224.76
|
| Rate for Payer: Heritage Provider Network Senior |
$224.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.00
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
|
|
HC ADENOVIRUS DNA QUANT
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900913624
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$344.74 |
| Rate for Payer: Adventist Health Commercial |
$54.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$146.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.20
|
| Rate for Payer: Blue Shield of California Commercial |
$344.74
|
| Rate for Payer: Blue Shield of California EPN |
$276.51
|
| Rate for Payer: Cash Price |
$123.30
|
| Rate for Payer: Cash Price |
$123.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$178.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Senior |
$42.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$169.61
|
| Rate for Payer: Heritage Provider Network Senior |
$169.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$61.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$130.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.98
|
| Rate for Payer: Multiplan Commercial |
$205.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.84
|
| Rate for Payer: TriValley Medical Group Senior |
$42.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$46.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$46.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC ADJACNT TISS TRNSF LT 10 SQ CM
|
Facility
|
OP
|
$9,935.00
|
|
|
Service Code
|
CPT 14040
|
| Hospital Charge Code |
900501289
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,987.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,825.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$4,470.75
|
| Rate for Payer: Cash Price |
$4,470.75
|
| Rate for Payer: Cash Price |
$4,470.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,457.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Senior |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,324.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,725.99
|
| Rate for Payer: Heritage Provider Network Senior |
$6,725.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,738.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,798.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,672.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,483.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,928.52
|
| Rate for Payer: Multiplan Commercial |
$7,451.25
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,574.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,289.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC ADJACNT TISS TRNSF LT 10 SQ CM
|
Facility
|
IP
|
$9,935.00
|
|
|
Service Code
|
CPT 14040
|
| Hospital Charge Code |
900501289
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,798.23 |
| Max. Negotiated Rate |
$7,451.25 |
| Rate for Payer: Adventist Health Commercial |
$1,987.00
|
| Rate for Payer: Cash Price |
$4,470.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,725.99
|
| Rate for Payer: Heritage Provider Network Senior |
$6,725.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,798.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,483.75
|
| Rate for Payer: Multiplan Commercial |
$7,451.25
|
|
|
HC ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
IP
|
$1,649.00
|
|
|
Service Code
|
CPT S2083
|
| Hospital Charge Code |
909020143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$298.47 |
| Max. Negotiated Rate |
$1,236.75 |
| Rate for Payer: Adventist Health Commercial |
$329.80
|
| Rate for Payer: Cash Price |
$742.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,116.37
|
| Rate for Payer: Heritage Provider Network Senior |
$1,116.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$298.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.25
|
| Rate for Payer: Multiplan Commercial |
$1,236.75
|
|
|
HC ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
IP
|
$5,527.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,000.39 |
| Max. Negotiated Rate |
$4,145.25 |
| Rate for Payer: Adventist Health Commercial |
$1,105.40
|
| Rate for Payer: Cash Price |
$2,487.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,741.78
|
| Rate for Payer: Heritage Provider Network Senior |
$3,741.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,000.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,381.75
|
| Rate for Payer: Multiplan Commercial |
$4,145.25
|
|
|
HC ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
OP
|
$2,772.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$554.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,904.36
|
| 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: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,801.80
|
| 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 |
$1,715.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,322.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$501.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$693.00
|
| 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 |
$2,079.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| 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 ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
OP
|
$2,772.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$554.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,904.36
|
| 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 |
$1,915.00
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,801.80
|
| 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 |
$1,876.64
|
| Rate for Payer: Heritage Provider Network Senior |
$1,876.64
|
| 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 |
$1,322.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$501.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$693.00
|
| 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 |
$2,079.00
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$997.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$917.81
|
| 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 ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
OP
|
$1,649.00
|
|
|
Service Code
|
CPT S2083
|
| Hospital Charge Code |
909020143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$329.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,132.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,401.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$906.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,236.75
|
| 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 |
$742.05
|
| Rate for Payer: Cash Price |
$742.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,071.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,401.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,401.65
|
| Rate for Payer: Dignity Health Senior |
$1,401.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$989.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,020.73
|
| Rate for Payer: Heritage Provider Network Senior |
$1,020.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$786.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$298.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,154.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,154.30
|
| Rate for Payer: Multiplan Commercial |
$1,236.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$824.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$824.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,401.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,401.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,401.65
|
|
|
HC ADJ GASTRIC BAND DIAM VIA PORT
|
Facility
|
IP
|
$5,527.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,000.39 |
| Max. Negotiated Rate |
$4,145.25 |
| Rate for Payer: Adventist Health Commercial |
$1,105.40
|
| Rate for Payer: Cash Price |
$2,487.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,741.78
|
| Rate for Payer: Heritage Provider Network Senior |
$3,741.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,000.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,381.75
|
| Rate for Payer: Multiplan Commercial |
$4,145.25
|
|
|
HC ADJ TISS TRNSFR 10 SQ CM OR LT
|
Facility
|
OP
|
$7,334.00
|
|
|
Service Code
|
CPT 14060
|
| Hospital Charge Code |
900501331
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,466.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,038.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$3,300.30
|
| Rate for Payer: Cash Price |
$3,300.30
|
| Rate for Payer: Cash Price |
$3,300.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,767.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Senior |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,324.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,965.12
|
| Rate for Payer: Heritage Provider Network Senior |
$4,965.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,498.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,327.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,672.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,833.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,928.52
|
| Rate for Payer: Multiplan Commercial |
$5,500.50
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,638.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,428.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
