|
HC BX BREAST 1ST LESION MR IMAG
|
Facility
|
IP
|
$4,593.00
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
900100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$831.33 |
| Max. Negotiated Rate |
$3,444.75 |
| Rate for Payer: Adventist Health Commercial |
$918.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,155.39
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,109.46
|
| Rate for Payer: Heritage Provider Network Senior |
$3,109.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.25
|
| Rate for Payer: Multiplan Commercial |
$3,444.75
|
|
|
HC BX BREAST 1ST LESION MR IMAG
|
Facility
|
OP
|
$4,593.00
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
900100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$259.62 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$918.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,155.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,985.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,843.07
|
| Rate for Payer: Heritage Provider Network Senior |
$2,491.60
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,848.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$3,444.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,228.26
|
| Rate for Payer: TriValley Medical Group Senior |
$2,228.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BX BREAST 1ST LESION STRTCTC
|
Facility
|
IP
|
$4,106.00
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
900100004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$743.19 |
| Max. Negotiated Rate |
$3,079.50 |
| Rate for Payer: Adventist Health Commercial |
$821.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,820.82
|
| Rate for Payer: Cash Price |
$1,847.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,779.76
|
| Rate for Payer: Heritage Provider Network Senior |
$2,779.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$743.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,026.50
|
| Rate for Payer: Multiplan Commercial |
$3,079.50
|
|
|
HC BX BREAST 1ST LESION STRTCTC
|
Facility
|
OP
|
$4,106.00
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
900100004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$743.19 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$821.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,820.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,847.70
|
| Rate for Payer: Cash Price |
$1,847.70
|
| Rate for Payer: Cash Price |
$1,847.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,668.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,541.61
|
| Rate for Payer: Heritage Provider Network Senior |
$2,491.60
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$986.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,848.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$743.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,026.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$3,079.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,228.26
|
| Rate for Payer: TriValley Medical Group Senior |
$2,228.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BX BREAST 1ST LESION US IMAG
|
Facility
|
IP
|
$4,969.00
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
900100006
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$899.39 |
| Max. Negotiated Rate |
$3,726.75 |
| Rate for Payer: Adventist Health Commercial |
$993.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,413.70
|
| Rate for Payer: Cash Price |
$2,236.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,364.01
|
| Rate for Payer: Heritage Provider Network Senior |
$3,364.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$899.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,242.25
|
| Rate for Payer: Multiplan Commercial |
$3,726.75
|
|
|
HC BX BREAST 1ST LESION US IMAG
|
Facility
|
OP
|
$4,969.00
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
900100006
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$899.39 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$993.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,413.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,085.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,916.80
|
| Rate for Payer: Cash Price |
$2,236.05
|
| Rate for Payer: Cash Price |
$2,236.05
|
| Rate for Payer: Cash Price |
$2,236.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,229.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,075.81
|
| Rate for Payer: Heritage Provider Network Senior |
$3,075.81
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$957.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,848.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$899.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,242.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$3,726.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,025.69
|
| Rate for Payer: TriValley Medical Group Senior |
$2,025.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BX BREAST ADD LESION MR IMAG
|
Facility
|
IP
|
$4,833.00
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
900100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$874.77 |
| Max. Negotiated Rate |
$3,624.75 |
| Rate for Payer: Adventist Health Commercial |
$966.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,320.27
|
| Rate for Payer: Cash Price |
$2,174.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,271.94
|
| Rate for Payer: Heritage Provider Network Senior |
$3,271.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$874.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.25
|
| Rate for Payer: Multiplan Commercial |
$3,624.75
|
|
|
HC BX BREAST ADD LESION MR IMAG
|
Facility
|
OP
|
$4,833.00
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
900100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$120.81 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$966.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,320.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,108.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,658.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,624.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,174.85
|
| Rate for Payer: Cash Price |
$2,174.85
|
| Rate for Payer: Cash Price |
$2,174.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,141.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,108.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,108.05
|
| Rate for Payer: Dignity Health Senior |
$4,108.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,991.63
|
| Rate for Payer: Heritage Provider Network Senior |
$2,991.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$120.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,329.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$874.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.25
|
| Rate for Payer: Multiplan Commercial |
$3,624.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,108.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,108.05
|
|
|
HC BX BREAST ADD LESION STRTCTC
|
Facility
|
OP
|
$4,028.00
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
900100005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$729.07 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$805.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,767.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,423.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,215.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,021.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$1,812.60
|
| Rate for Payer: Cash Price |
$1,812.60
|
| Rate for Payer: Cash Price |
$1,812.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,618.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,423.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,423.80
|
| Rate for Payer: Dignity Health Senior |
$3,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,493.33
|
| Rate for Payer: Heritage Provider Network Senior |
$2,493.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$821.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,941.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.00
|
| Rate for Payer: Multiplan Commercial |
$3,021.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,423.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,423.80
|
|
|
HC BX BREAST ADD LESION STRTCTC
|
Facility
|
IP
|
$4,028.00
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
900100005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$729.07 |
| Max. Negotiated Rate |
$3,021.00 |
| Rate for Payer: Adventist Health Commercial |
$805.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,767.24
|
| Rate for Payer: Cash Price |
$1,812.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,726.96
|
| Rate for Payer: Heritage Provider Network Senior |
$2,726.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$729.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.00
|
| Rate for Payer: Multiplan Commercial |
$3,021.00
|
|
|
HC BX BREAST ADD LESION US IMAG
|
Facility
|
OP
|
$3,026.00
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
900100007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$547.71 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$605.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,078.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,572.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,664.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,269.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,879.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,776.26
|
| Rate for Payer: Cash Price |
$1,361.70
|
| Rate for Payer: Cash Price |
$1,361.70
|
| Rate for Payer: Cash Price |
$1,361.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,966.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,572.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,572.10
|
| Rate for Payer: Dignity Health Senior |
$2,572.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,873.09
|
| Rate for Payer: Heritage Provider Network Senior |
$1,873.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$790.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,458.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$547.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$756.50
|
| Rate for Payer: Multiplan Commercial |
$2,269.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,572.10
|
| Rate for Payer: Vantage Medical Group Senior |
$2,572.10
|
|
|
HC BX BREAST ADD LESION US IMAG
|
Facility
|
IP
|
$3,026.00
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
900100007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$547.71 |
| Max. Negotiated Rate |
$2,269.50 |
| Rate for Payer: Adventist Health Commercial |
$605.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,078.86
|
| Rate for Payer: Cash Price |
$1,361.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,048.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,048.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$547.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$756.50
|
| Rate for Payer: Multiplan Commercial |
$2,269.50
|
|
|
HC BX BREAST PERCUT W/O IMAGE
|
Facility
|
OP
|
$1,076.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
900501761
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$194.76 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$739.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$484.20
|
| Rate for Payer: Cash Price |
$484.20
|
| Rate for Payer: Cash Price |
$484.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$699.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$728.45
|
| Rate for Payer: Heritage Provider Network Senior |
$728.45
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$518.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$807.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$359.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BX BREAST PERCUT W/O IMAGE
|
Facility
|
IP
|
$1,076.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
900501761
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$194.76 |
| Max. Negotiated Rate |
$807.00 |
| Rate for Payer: Adventist Health Commercial |
$215.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$739.21
|
| Rate for Payer: Cash Price |
$484.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$728.45
|
| Rate for Payer: Heritage Provider Network Senior |
$728.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.00
|
| Rate for Payer: Multiplan Commercial |
$807.00
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.69 |
| Max. Negotiated Rate |
$1,370.25 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,255.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,236.88
|
| Rate for Payer: Heritage Provider Network Senior |
$1,236.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$456.75
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.41 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,255.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,187.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: Dignity Health Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,130.91
|
| Rate for Payer: Heritage Provider Network Senior |
$1,081.26
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$78.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,670.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$456.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,107.63
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$966.98
|
| Rate for Payer: TriValley Medical Group Senior |
$966.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC C-14 UREA BREATH TEST ACQ
|
Facility
|
OP
|
$389.00
|
|
|
Service Code
|
CPT 78267
|
| Hospital Charge Code |
909301257
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$11.06 |
| Max. Negotiated Rate |
$291.75 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.06
|
| Rate for Payer: Blue Shield of California Commercial |
$241.57
|
| Rate for Payer: Blue Shield of California EPN |
$228.34
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$252.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.17
|
| Rate for Payer: Dignity Health Senior |
$11.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$240.79
|
| Rate for Payer: Heritage Provider Network Senior |
$240.79
|
| Rate for Payer: Humana Medicare |
$11.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.94
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.17
|
| Rate for Payer: TriValley Medical Group Senior |
$11.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.17
|
| Rate for Payer: Vantage Medical Group Senior |
$11.06
|
|
|
HC C-14 UREA BREATH TEST ACQ
|
Facility
|
IP
|
$389.00
|
|
|
Service Code
|
CPT 78267
|
| Hospital Charge Code |
909301257
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$70.41 |
| Max. Negotiated Rate |
$291.75 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.24
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$263.35
|
| Rate for Payer: Heritage Provider Network Senior |
$263.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.25
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
|
|
HC C-14 UREA BREATH TEST ANAL
|
Facility
|
OP
|
$433.00
|
|
|
Service Code
|
CPT 78268
|
| Hospital Charge Code |
909301258
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$78.37 |
| Max. Negotiated Rate |
$324.75 |
| Rate for Payer: Adventist Health Commercial |
$86.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$211.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$297.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$141.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$103.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.41
|
| Rate for Payer: Blue Shield of California Commercial |
$268.89
|
| Rate for Payer: Blue Shield of California EPN |
$254.17
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$281.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$141.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$103.85
|
| Rate for Payer: Dignity Health Senior |
$94.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$94.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.03
|
| Rate for Payer: Heritage Provider Network Senior |
$268.03
|
| Rate for Payer: Humana Medicare |
$94.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$94.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$179.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$118.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$118.96
|
| Rate for Payer: Multiplan Commercial |
$324.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$103.85
|
| Rate for Payer: TriValley Medical Group Senior |
$94.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$141.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$103.85
|
| Rate for Payer: Vantage Medical Group Senior |
$94.41
|
|
|
HC C-14 UREA BREATH TEST ANAL
|
Facility
|
IP
|
$433.00
|
|
|
Service Code
|
CPT 78268
|
| Hospital Charge Code |
909301258
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$78.37 |
| Max. Negotiated Rate |
$324.75 |
| Rate for Payer: Adventist Health Commercial |
$86.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$297.47
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$293.14
|
| Rate for Payer: Heritage Provider Network Senior |
$293.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.25
|
| Rate for Payer: Multiplan Commercial |
$324.75
|
|
|
HC CA CALCIUM IONIZED
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900910502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$114.39 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.39
|
| Rate for Payer: Blue Shield of California Commercial |
$106.71
|
| Rate for Payer: Blue Shield of California EPN |
$83.42
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$13.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.24
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.68
|
| Rate for Payer: TriValley Medical Group Senior |
$13.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC CA CALCIUM IONIZED
|
Facility
|
IP
|
$342.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900910502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.90 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Adventist Health Commercial |
$68.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$234.95
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$231.53
|
| Rate for Payer: Heritage Provider Network Senior |
$231.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.50
|
| Rate for Payer: Multiplan Commercial |
$256.50
|
|
|
HC CAFFEINE SERUM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900910538
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$121.89 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.89
|
| Rate for Payer: Blue Shield of California Commercial |
$106.94
|
| Rate for Payer: Blue Shield of California EPN |
$83.60
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.50
|
| Rate for Payer: Dignity Health Senior |
$18.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.24
|
| Rate for Payer: Heritage Provider Network Senior |
$27.24
|
| Rate for Payer: Humana Medicare |
$18.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.49
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.64
|
| Rate for Payer: TriValley Medical Group Senior |
$18.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Vantage Medical Group Senior |
$18.64
|
|
|
HC CAFFEINE SERUM
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900910538
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.32 |
| Max. Negotiated Rate |
$121.50 |
| Rate for Payer: Adventist Health Commercial |
$32.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.29
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$109.67
|
| Rate for Payer: Heritage Provider Network Senior |
$109.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
|
|
HC CA IONIZED (POC)
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900912118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$219.00 |
| Rate for Payer: Adventist Health Commercial |
$58.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.39
|
| Rate for Payer: Blue Shield of California Commercial |
$106.71
|
| Rate for Payer: Blue Shield of California EPN |
$83.42
|
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$189.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$180.75
|
| Rate for Payer: Heritage Provider Network Senior |
$180.75
|
| Rate for Payer: Humana Medicare |
$13.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.24
|
| Rate for Payer: Multiplan Commercial |
$219.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.68
|
| Rate for Payer: TriValley Medical Group Senior |
$13.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
