|
HC ATHRECTOMY FEM/POP
|
Facility
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
906820149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,814.78 |
| Max. Negotiated Rate |
$19,950.75 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,008.88
|
| Rate for Payer: Heritage Provider Network Senior |
$18,008.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,814.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,650.25
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
IP
|
$29,550.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.55 |
| Max. Negotiated Rate |
$22,162.50 |
| Rate for Payer: Adventist Health Commercial |
$5,910.00
|
| Rate for Payer: Cash Price |
$16,252.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,005.35
|
| Rate for Payer: Heritage Provider Network Senior |
$20,005.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,348.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,387.50
|
| Rate for Payer: Multiplan Commercial |
$22,162.50
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
OP
|
$29,550.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$5,910.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,300.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$16,252.50
|
| Rate for Payer: Cash Price |
$16,252.50
|
| Rate for Payer: Cash Price |
$16,252.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,207.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,730.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,291.45
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,348.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,387.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$22,162.50
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| 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 |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
IP
|
$30,748.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,565.39 |
| Max. Negotiated Rate |
$23,061.00 |
| Rate for Payer: Adventist Health Commercial |
$6,149.60
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,816.40
|
| Rate for Payer: Heritage Provider Network Senior |
$20,816.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,565.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,687.00
|
| Rate for Payer: Multiplan Commercial |
$23,061.00
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
OP
|
$30,748.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$6,149.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,123.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,986.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,448.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,033.01
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,565.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,687.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$23,061.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| 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 |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY RENAL
|
Facility
|
OP
|
$36,702.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,526.50 |
| Rate for Payer: Adventist Health Commercial |
$7,340.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25,214.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$20,186.10
|
| Rate for Payer: Cash Price |
$20,186.10
|
| Rate for Payer: Cash Price |
$20,186.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23,856.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,021.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,718.54
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,643.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,175.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$27,526.50
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| 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 |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHRECTOMY RENAL
|
Facility
|
IP
|
$30,748.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,565.39 |
| Max. Negotiated Rate |
$23,061.00 |
| Rate for Payer: Adventist Health Commercial |
$6,149.60
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,816.40
|
| Rate for Payer: Heritage Provider Network Senior |
$20,816.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,565.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,687.00
|
| Rate for Payer: Multiplan Commercial |
$23,061.00
|
|
|
HC ATHRECTOMY RENAL
|
Facility
|
IP
|
$36,702.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,643.06 |
| Max. Negotiated Rate |
$27,526.50 |
| Rate for Payer: Adventist Health Commercial |
$7,340.40
|
| Rate for Payer: Cash Price |
$20,186.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,847.25
|
| Rate for Payer: Heritage Provider Network Senior |
$24,847.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,643.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,175.50
|
| Rate for Payer: Multiplan Commercial |
$27,526.50
|
|
|
HC ATHRECTOMY RENAL
|
Facility
|
OP
|
$30,748.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$6,149.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,123.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cash Price |
$16,911.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,986.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,448.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,033.01
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,565.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,687.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$23,061.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| 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 |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
OP
|
$47,060.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32,330.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30,589.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,130.14
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,517.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,765.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$35,295.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
OP
|
$37,843.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$7,568.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25,998.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$20,813.65
|
| Rate for Payer: Cash Price |
$20,813.65
|
| Rate for Payer: Cash Price |
$20,813.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24,597.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,424.82
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,849.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,460.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$28,382.25
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
IP
|
$37,843.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,849.58 |
| Max. Negotiated Rate |
$28,382.25 |
| Rate for Payer: Adventist Health Commercial |
$7,568.60
|
| Rate for Payer: Cash Price |
$20,813.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,619.71
|
| Rate for Payer: Heritage Provider Network Senior |
$25,619.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,849.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,460.75
|
| Rate for Payer: Multiplan Commercial |
$28,382.25
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
IP
|
$47,060.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,517.86 |
| Max. Negotiated Rate |
$35,295.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$31,859.62
|
| Rate for Payer: Heritage Provider Network Senior |
$31,859.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,517.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,765.00
|
| Rate for Payer: Multiplan Commercial |
$35,295.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,520.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,422.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,485.50
|
| 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 |
$8,422.70
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,954.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,016.90
|
| Rate for Payer: Dignity Health Senior |
$13,016.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,479.37
|
| Rate for Payer: Heritage Provider Network Senior |
$9,479.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,304.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,771.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,719.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,719.80
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,016.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13,016.90
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
OP
|
$13,017.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,942.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,159.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,762.75
|
| 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 |
$7,159.35
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,461.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,064.45
|
| Rate for Payer: Dignity Health Senior |
$11,064.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,057.52
|
| Rate for Payer: Heritage Provider Network Senior |
$8,057.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,209.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,356.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,254.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,111.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,111.90
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,064.45
|
| Rate for Payer: Vantage Medical Group Senior |
$11,064.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
IP
|
$13,017.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,356.08 |
| Max. Negotiated Rate |
$9,762.75 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,812.51
|
| Rate for Payer: Heritage Provider Network Senior |
$8,812.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,356.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,254.25
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,771.83 |
| Max. Negotiated Rate |
$11,485.50 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,367.58
|
| Rate for Payer: Heritage Provider Network Senior |
$10,367.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,771.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.50
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$22,445.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$4,489.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,419.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$12,344.75
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,589.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,893.45
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,062.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,611.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$16,833.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,517.86 |
| Max. Negotiated Rate |
$35,295.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$31,859.62
|
| Rate for Payer: Heritage Provider Network Senior |
$31,859.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,517.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,765.00
|
| Rate for Payer: Multiplan Commercial |
$35,295.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32,330.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30,589.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,130.14
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,517.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,765.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$35,295.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$22,445.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,062.55 |
| Max. Negotiated Rate |
$16,833.75 |
| Rate for Payer: Adventist Health Commercial |
$4,489.00
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,195.26
|
| Rate for Payer: Heritage Provider Network Senior |
$15,195.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,062.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,611.25
|
| Rate for Payer: Multiplan Commercial |
$16,833.75
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,814.78 |
| Max. Negotiated Rate |
$19,950.75 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,008.88
|
| Rate for Payer: Heritage Provider Network Senior |
$18,008.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,814.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,650.25
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
IP
|
$22,445.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,062.55 |
| Max. Negotiated Rate |
$16,833.75 |
| Rate for Payer: Adventist Health Commercial |
$4,489.00
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,195.26
|
| Rate for Payer: Heritage Provider Network Senior |
$15,195.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,062.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,611.25
|
| Rate for Payer: Multiplan Commercial |
$16,833.75
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,274.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,290.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,466.02
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$198.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,814.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,650.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| 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 |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$22,445.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$4,489.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,419.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$12,344.75
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Cash Price |
$12,344.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,589.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,893.45
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$198.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,062.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,611.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$16,833.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| 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 |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
