|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$754.50 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$681.06
|
| Rate for Payer: Heritage Provider Network Senior |
$681.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$251.50
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
OP
|
$978.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
906820177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$71.17 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$195.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,699.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$671.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$831.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$537.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$733.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$537.90
|
| Rate for Payer: Cash Price |
$537.90
|
| Rate for Payer: Cash Price |
$537.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$635.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$831.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$831.30
|
| Rate for Payer: Dignity Health Senior |
$831.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$605.38
|
| Rate for Payer: Heritage Provider Network Senior |
$605.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$466.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.60
|
| Rate for Payer: Multiplan Commercial |
$733.50
|
| 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 |
$831.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$831.30
|
| Rate for Payer: Vantage Medical Group Senior |
$831.30
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$195.66 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,699.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$742.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$918.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$594.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$810.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$702.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$918.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$918.85
|
| Rate for Payer: Dignity Health Senior |
$918.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$669.14
|
| Rate for Payer: Heritage Provider Network Senior |
$669.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$425.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$515.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$756.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$756.70
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
| 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 |
$918.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$918.85
|
| Rate for Payer: Vantage Medical Group Senior |
$918.85
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$1,051.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
906820178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$190.23 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$210.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,699.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$722.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$893.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$578.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$788.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$683.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$893.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$893.35
|
| Rate for Payer: Dignity Health Senior |
$893.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$650.57
|
| Rate for Payer: Heritage Provider Network Senior |
$650.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$425.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$501.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$190.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$735.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$735.70
|
| Rate for Payer: Multiplan Commercial |
$788.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$893.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$893.35
|
| Rate for Payer: Vantage Medical Group Senior |
$893.35
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$195.66 |
| Max. Negotiated Rate |
$810.75 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$731.84
|
| Rate for Payer: Heritage Provider Network Senior |
$731.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.25
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$1,051.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
906820178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$190.23 |
| Max. Negotiated Rate |
$788.25 |
| Rate for Payer: Adventist Health Commercial |
$210.20
|
| Rate for Payer: Cash Price |
$578.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$711.53
|
| Rate for Payer: Heritage Provider Network Senior |
$711.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$190.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.75
|
| Rate for Payer: Multiplan Commercial |
$788.25
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
906820099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$705.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$872.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$564.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$770.25
|
| 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 |
$564.85
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$667.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$872.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$872.95
|
| Rate for Payer: Dignity Health Senior |
$872.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$635.71
|
| Rate for Payer: Heritage Provider Network Senior |
$635.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$68.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$489.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$718.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$718.90
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$872.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$872.95
|
| Rate for Payer: Vantage Medical Group Senior |
$872.95
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$916.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.80 |
| Max. Negotiated Rate |
$687.00 |
| Rate for Payer: Adventist Health Commercial |
$183.20
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$620.13
|
| Rate for Payer: Heritage Provider Network Senior |
$620.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.00
|
| Rate for Payer: Multiplan Commercial |
$687.00
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$916.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.80 |
| Max. Negotiated Rate |
$687.00 |
| Rate for Payer: Adventist Health Commercial |
$183.20
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$620.13
|
| Rate for Payer: Heritage Provider Network Senior |
$620.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.00
|
| Rate for Payer: Multiplan Commercial |
$687.00
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
906820099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.89 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$695.28
|
| Rate for Payer: Heritage Provider Network Senior |
$695.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.75
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$916.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$183.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$629.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$778.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$503.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$595.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$778.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$778.60
|
| Rate for Payer: Dignity Health Senior |
$778.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$620.13
|
| Rate for Payer: Heritage Provider Network Senior |
$620.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$436.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$641.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$641.20
|
| Rate for Payer: Multiplan Commercial |
$687.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$329.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$303.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$778.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$778.60
|
| Rate for Payer: Vantage Medical Group Senior |
$778.60
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$916.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$183.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$629.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$778.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$503.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.00
|
| 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 |
$503.80
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Cash Price |
$503.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$595.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$778.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$778.60
|
| Rate for Payer: Dignity Health Senior |
$778.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$567.00
|
| Rate for Payer: Heritage Provider Network Senior |
$567.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$68.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$436.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$641.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$641.20
|
| Rate for Payer: Multiplan Commercial |
$687.00
|
| 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 |
$778.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$778.60
|
| Rate for Payer: Vantage Medical Group Senior |
$778.60
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
IP
|
$11,253.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
906820193
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,036.79 |
| Max. Negotiated Rate |
$8,439.75 |
| Rate for Payer: Adventist Health Commercial |
$2,250.60
|
| Rate for Payer: Cash Price |
$6,189.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,618.28
|
| Rate for Payer: Heritage Provider Network Senior |
$7,618.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,036.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,813.25
|
| Rate for Payer: Multiplan Commercial |
$8,439.75
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
IP
|
$6,064.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,097.58 |
| Max. Negotiated Rate |
$4,548.00 |
| Rate for Payer: Adventist Health Commercial |
$1,212.80
|
| Rate for Payer: Cash Price |
$3,335.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,105.33
|
| Rate for Payer: Heritage Provider Network Senior |
$4,105.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,097.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,516.00
|
| Rate for Payer: Multiplan Commercial |
$4,548.00
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
OP
|
$11,253.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
906820193
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$209.55 |
| Max. Negotiated Rate |
$10,302.72 |
| Rate for Payer: Adventist Health Commercial |
$2,250.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,014.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,730.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.28
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$6,189.15
|
| Rate for Payer: Cash Price |
$6,189.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,314.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,314.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,965.61
|
| Rate for Payer: Heritage Provider Network Senior |
$6,965.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,367.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,036.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,813.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$8,439.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,868.48
|
| Rate for Payer: TriValley Medical Group Senior |
$6,868.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
OP
|
$6,064.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$209.55 |
| Max. Negotiated Rate |
$10,302.72 |
| Rate for Payer: Adventist Health Commercial |
$1,212.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,241.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,165.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.28
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$3,335.20
|
| Rate for Payer: Cash Price |
$3,335.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,941.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,753.62
|
| Rate for Payer: Heritage Provider Network Senior |
$3,753.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,892.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,097.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,516.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$4,548.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,868.48
|
| Rate for Payer: TriValley Medical Group Senior |
$6,868.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$440.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$416.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Senior |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$375.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$433.96
|
| Rate for Payer: Heritage Provider Network Senior |
$433.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$305.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$431.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$472.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$472.59
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$230.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$212.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.02 |
| Max. Negotiated Rate |
$480.75 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$433.96
|
| Rate for Payer: Heritage Provider Network Senior |
$433.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.25
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$440.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$391.01
|
| Rate for Payer: Blue Shield of California EPN |
$312.81
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$416.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Senior |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$375.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$396.78
|
| Rate for Payer: Heritage Provider Network Senior |
$396.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$61.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$305.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$431.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$472.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$472.59
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$412.58
|
| Rate for Payer: TriValley Medical Group Senior |
$375.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$320.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$320.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$116.02 |
| Max. Negotiated Rate |
$480.75 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Cash Price |
$352.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$433.96
|
| Rate for Payer: Heritage Provider Network Senior |
$433.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.25
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.70 |
| Max. Negotiated Rate |
$438.00 |
| Rate for Payer: Adventist Health Commercial |
$116.80
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$395.37
|
| Rate for Payer: Heritage Provider Network Senior |
$395.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$584.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$116.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$401.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$379.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Senior |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$375.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$395.37
|
| Rate for Payer: Heritage Provider Network Senior |
$395.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$278.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$431.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$472.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$472.59
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$210.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$193.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$584.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$116.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$401.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| 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 |
$321.20
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$379.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Senior |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$375.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$361.50
|
| Rate for Payer: Heritage Provider Network Senior |
$461.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$52.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$712.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$431.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$472.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$472.59
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: TriValley Medical Group Commercial |
$412.58
|
| Rate for Payer: TriValley Medical Group Senior |
$412.58
|
| 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 |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$105.70 |
| Max. Negotiated Rate |
$438.00 |
| Rate for Payer: Adventist Health Commercial |
$116.80
|
| Rate for Payer: Cash Price |
$321.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$395.37
|
| Rate for Payer: Heritage Provider Network Senior |
$395.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
|
|
HC ARTHRDSIS POST INTRBDY LMBR
|
Facility
|
OP
|
$77,449.00
|
|
|
Service Code
|
CPT 22630
|
| Hospital Charge Code |
900100963
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$58,086.75 |
| Rate for Payer: Adventist Health Commercial |
$15,489.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$53,207.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,049.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,703.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,366.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,680.00
|
| 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 |
$42,596.95
|
| Rate for Payer: Cash Price |
$42,596.95
|
| Rate for Payer: Cash Price |
$42,596.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50,341.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,049.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,703.04
|
| Rate for Payer: Dignity Health Senior |
$23,366.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$23,366.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$47,940.93
|
| Rate for Payer: Heritage Provider Network Senior |
$28,740.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,822.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,366.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$44,396.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,018.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,871.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,362.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,441.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,441.66
|
| Rate for Payer: Multiplan Commercial |
$58,086.75
|
| Rate for Payer: Multiplan WC |
$37,230.18
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,703.04
|
| Rate for Payer: TriValley Medical Group Senior |
$25,703.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,049.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,703.04
|
| Rate for Payer: Vantage Medical Group Senior |
$23,366.40
|
|
