|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$10,402.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,882.76 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$2,080.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,146.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,841.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,721.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,801.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$5,721.10
|
| Rate for Payer: Cash Price |
$5,721.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,761.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,841.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,841.70
|
| Rate for Payer: Dignity Health Senior |
$8,841.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,241.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,438.84
|
| Rate for Payer: Heritage Provider Network Senior |
$6,438.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,961.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,882.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,600.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,281.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,281.40
|
| Rate for Payer: Multiplan Commercial |
$7,801.50
|
| 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 |
$8,841.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,841.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,841.70
|
|
|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$10,402.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,882.76 |
| Max. Negotiated Rate |
$7,801.50 |
| Rate for Payer: Adventist Health Commercial |
$2,080.40
|
| Rate for Payer: Cash Price |
$5,721.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,042.15
|
| Rate for Payer: Heritage Provider Network Senior |
$7,042.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,882.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,600.50
|
| Rate for Payer: Multiplan Commercial |
$7,801.50
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,858.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$336.30 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$371.60
|
| Rate for Payer: Cash Price |
$1,021.90
|
| Rate for Payer: Cash Price |
$1,021.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$464.50
|
| Rate for Payer: Multiplan Commercial |
$1,393.50
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,858.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$250.60 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$371.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7,402.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,276.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,579.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,021.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,393.50
|
| 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 |
$1,021.90
|
| Rate for Payer: Cash Price |
$1,021.90
|
| Rate for Payer: Cash Price |
$1,021.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,579.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,579.30
|
| Rate for Payer: Dignity Health Senior |
$1,579.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,207.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$886.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$464.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,300.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,300.60
|
| Rate for Payer: Multiplan Commercial |
$1,393.50
|
| 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 |
$1,579.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,579.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,579.30
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$276.93 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$250.60 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7,402.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,051.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$841.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,147.50
|
| 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 |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,300.50
|
| Rate for Payer: Dignity Health Senior |
$1,300.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$994.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$947.07
|
| Rate for Payer: Heritage Provider Network Senior |
$947.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$729.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,071.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,071.00
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| 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 |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,300.50
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$333.75 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$301.26
|
| Rate for Payer: Heritage Provider Network Senior |
$301.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
OP
|
$445.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$305.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$244.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$333.75
|
| 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 |
$244.75
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$289.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$378.25
|
| Rate for Payer: Dignity Health Senior |
$378.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$275.45
|
| Rate for Payer: Heritage Provider Network Senior |
$275.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$212.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.50
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
| 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 |
$378.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$378.25
|
| Rate for Payer: Vantage Medical Group Senior |
$378.25
|
|
|
HC ANKLE COMPLETE
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.40 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$498.95
|
| Rate for Payer: Heritage Provider Network Senior |
$498.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.25
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
|
|
HC ANKLE COMPLETE
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.73 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$393.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$506.32
|
| 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 |
$138.54
|
| Rate for Payer: Blue Shield of California Commercial |
$109.97
|
| Rate for Payer: Blue Shield of California EPN |
$88.43
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$479.05
|
| 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 |
$479.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$456.20
|
| Rate for Payer: Heritage Provider Network Senior |
$456.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$351.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.25
|
| 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 |
$552.75
|
| 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 |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| 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 ANKLE LIMITED
|
Facility
|
IP
|
$547.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$99.01 |
| Max. Negotiated Rate |
$410.25 |
| Rate for Payer: Adventist Health Commercial |
$109.40
|
| Rate for Payer: Cash Price |
$300.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$370.32
|
| Rate for Payer: Heritage Provider Network Senior |
$370.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.75
|
| Rate for Payer: Multiplan Commercial |
$410.25
|
|
|
HC ANKLE LIMITED
|
Facility
|
OP
|
$547.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.81 |
| Max. Negotiated Rate |
$410.25 |
| Rate for Payer: Adventist Health Commercial |
$109.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$292.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$375.79
|
| 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 |
$128.83
|
| Rate for Payer: Blue Shield of California Commercial |
$101.86
|
| Rate for Payer: Blue Shield of California EPN |
$81.91
|
| Rate for Payer: Cash Price |
$300.85
|
| Rate for Payer: Cash Price |
$300.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$355.55
|
| 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 |
$355.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$338.59
|
| Rate for Payer: Heritage Provider Network Senior |
$338.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$260.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.75
|
| 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 |
$410.25
|
| 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 |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| 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 ANORECTAL MANOMETRY
|
Facility
|
IP
|
$2,224.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$402.54 |
| Max. Negotiated Rate |
$1,668.00 |
| Rate for Payer: Adventist Health Commercial |
$444.80
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,505.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,505.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$402.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$556.00
|
| Rate for Payer: Multiplan Commercial |
$1,668.00
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$2,224.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$97.80 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$444.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,188.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,527.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| 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 |
$1,223.20
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,445.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Senior |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,334.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,376.66
|
| Rate for Payer: Heritage Provider Network Senior |
$486.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$97.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,060.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$402.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$556.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$498.53
|
| Rate for Payer: Multiplan Commercial |
$1,668.00
|
| 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 |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$223.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$211.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$220.03
|
| Rate for Payer: Heritage Provider Network Senior |
$220.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$155.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$116.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$107.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.83 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$220.03
|
| Rate for Payer: Heritage Provider Network Senior |
$220.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.25
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$3,249.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$588.07 |
| Max. Negotiated Rate |
$2,436.75 |
| Rate for Payer: Adventist Health Commercial |
$649.80
|
| Rate for Payer: Cash Price |
$1,786.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,199.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,199.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$588.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.25
|
| Rate for Payer: Multiplan Commercial |
$2,436.75
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$3,249.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$649.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,232.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,786.95
|
| Rate for Payer: Cash Price |
$1,786.95
|
| Rate for Payer: Cash Price |
$1,786.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,111.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Senior |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,158.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,199.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,199.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,549.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$588.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,332.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,459.61
|
| Rate for Payer: Multiplan Commercial |
$2,436.75
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,168.99
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,075.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$137.74 |
| Max. Negotiated Rate |
$570.75 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$515.20
|
| Rate for Payer: Heritage Provider Network Senior |
$515.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.25
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.76 |
| Max. Negotiated Rate |
$685.59 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$406.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$522.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.41
|
| Rate for Payer: Blue Shield of California Commercial |
$167.66
|
| Rate for Payer: Blue Shield of California EPN |
$134.83
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$494.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Senior |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$457.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$471.06
|
| Rate for Payer: Heritage Provider Network Senior |
$471.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$363.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$525.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$575.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$575.90
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$457.06
|
| Rate for Payer: TriValley Medical Group Senior |
$457.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$321.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$321.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$300.75 |
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$214.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$275.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.59
|
| Rate for Payer: Blue Shield of California Commercial |
$94.94
|
| Rate for Payer: Blue Shield of California EPN |
$76.35
|
| Rate for Payer: Cash Price |
$220.55
|
| Rate for Payer: Cash Price |
$220.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$260.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.68
|
| Rate for Payer: Dignity Health Senior |
$67.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$248.22
|
| Rate for Payer: Heritage Provider Network Senior |
$248.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$191.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85.54
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.89
|
| Rate for Payer: TriValley Medical Group Senior |
$67.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Vantage Medical Group Senior |
$67.89
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.58 |
| Max. Negotiated Rate |
$300.75 |
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Cash Price |
$220.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$271.48
|
| Rate for Payer: Heritage Provider Network Senior |
$271.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.25
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
IP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$103.35 |
| Max. Negotiated Rate |
$428.25 |
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Cash Price |
$314.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$386.57
|
| Rate for Payer: Heritage Provider Network Senior |
$386.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.75
|
| Rate for Payer: Multiplan Commercial |
$428.25
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
OP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$428.25 |
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$305.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$392.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$314.05
|
| Rate for Payer: Cash Price |
$314.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$371.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$371.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$353.45
|
| Rate for Payer: Heritage Provider Network Senior |
$353.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$272.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$428.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC ANTIGEN TYPING PATIENT
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
900904701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$685.59 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$176.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$227.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.91
|
| Rate for Payer: Blue Shield of California Commercial |
$30.76
|
| Rate for Payer: Blue Shield of California EPN |
$24.67
|
| Rate for Payer: Cash Price |
$182.05
|
| Rate for Payer: Cash Price |
$182.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$215.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Senior |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$457.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$204.89
|
| Rate for Payer: Heritage Provider Network Senior |
$204.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$157.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$525.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$575.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$575.90
|
| Rate for Payer: Multiplan Commercial |
$248.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$457.06
|
| Rate for Payer: TriValley Medical Group Senior |
$457.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
