|
HC BFLEX 3.8 BRONCHOSCOPE
|
Facility
|
OP
|
$5,180.00
|
|
| Hospital Charge Code |
900831703
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$4,403.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,768.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,558.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,849.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,159.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,527.84
|
| Rate for Payer: Cash Price |
$2,849.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,367.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,403.00
|
| Rate for Payer: Dignity Health Senior |
$4,403.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,367.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,206.42
|
| Rate for Payer: Heritage Provider Network Senior |
$3,206.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,470.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,626.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,626.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,590.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,590.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,403.00
|
|
|
HC BFLEX 5.0 BRONCHOSCOPE
|
Facility
|
OP
|
$5,180.00
|
|
| Hospital Charge Code |
900831701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$4,403.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,768.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,558.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,849.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,159.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,527.84
|
| Rate for Payer: Cash Price |
$2,849.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,367.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,403.00
|
| Rate for Payer: Dignity Health Senior |
$4,403.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,367.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,206.42
|
| Rate for Payer: Heritage Provider Network Senior |
$3,206.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,470.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,626.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,626.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,590.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,590.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,403.00
|
|
|
HC BFLEX 5.0 BRONCHOSCOPE
|
Facility
|
IP
|
$5,180.00
|
|
| Hospital Charge Code |
900831701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$3,885.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Cash Price |
$2,849.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,506.86
|
| Rate for Payer: Heritage Provider Network Senior |
$3,506.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
|
|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
IP
|
$1,195.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.29 |
| Max. Negotiated Rate |
$896.25 |
| Rate for Payer: Adventist Health Commercial |
$239.00
|
| Rate for Payer: Cash Price |
$657.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$809.01
|
| Rate for Payer: Heritage Provider Network Senior |
$809.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.75
|
| Rate for Payer: Multiplan Commercial |
$896.25
|
|
|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
OP
|
$1,195.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.29 |
| Max. Negotiated Rate |
$1,015.75 |
| Rate for Payer: Adventist Health Commercial |
$239.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$638.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$820.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$657.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$896.25
|
| Rate for Payer: Blue Shield of California Commercial |
$728.95
|
| Rate for Payer: Blue Shield of California EPN |
$583.16
|
| Rate for Payer: Cash Price |
$657.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$776.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,015.75
|
| Rate for Payer: Dignity Health Senior |
$1,015.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$776.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$739.71
|
| Rate for Payer: Heritage Provider Network Senior |
$739.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$570.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$836.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$836.50
|
| Rate for Payer: Multiplan Commercial |
$896.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$597.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$597.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,015.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,015.75
|
|
|
HC BG ARTERIAL PUNCTURE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.33
|
| Rate for Payer: Heritage Provider Network Senior |
$43.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
|
|
HC BG ARTERIAL PUNCTURE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$34.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43.97
|
| 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: Blue Shield of California Commercial |
$39.04
|
| Rate for Payer: Blue Shield of California EPN |
$31.23
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.60
|
| 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 |
$39.62
|
| Rate for Payer: Heritage Provider Network Senior |
$39.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| 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 |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$180.16
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$32.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$32.00
|
| 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 BG IONIZED CALCIUM
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$243.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$312.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.77
|
| Rate for Payer: Blue Shield of California Commercial |
$109.96
|
| Rate for Payer: Blue Shield of California EPN |
$88.20
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$295.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$281.64
|
| Rate for Payer: Heritage Provider Network Senior |
$281.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$217.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.24
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.68
|
| Rate for Payer: TriValley Medical Group Senior |
$13.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC BG IONIZED CALCIUM
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$82.36 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$308.04
|
| Rate for Payer: Heritage Provider Network Senior |
$308.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
IP
|
$14,725.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,665.22 |
| Max. Negotiated Rate |
$11,043.75 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,968.83
|
| Rate for Payer: Heritage Provider Network Senior |
$9,968.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,665.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,681.25
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
OP
|
$14,725.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$11,043.75 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,116.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| 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 |
$8,098.75
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,571.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,114.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,643.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,665.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,681.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
IP
|
$11,361.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,056.34 |
| Max. Negotiated Rate |
$8,520.75 |
| Rate for Payer: Adventist Health Commercial |
$2,272.20
|
| Rate for Payer: Cash Price |
$6,248.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,691.40
|
| Rate for Payer: Heritage Provider Network Senior |
$7,691.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,056.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,840.25
|
| Rate for Payer: Multiplan Commercial |
$8,520.75
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
OP
|
$11,361.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$15,063.64 |
| Rate for Payer: Adventist Health Commercial |
$2,272.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,805.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,892.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,721.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,928.23
|
| 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 |
$6,248.55
|
| Rate for Payer: Cash Price |
$6,248.55
|
| Rate for Payer: Cash Price |
$6,248.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,384.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,892.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,721.05
|
| Rate for Payer: Dignity Health Senior |
$7,928.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,928.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,032.46
|
| Rate for Payer: Heritage Provider Network Senior |
$9,751.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$392.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,928.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15,063.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,056.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,117.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,840.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,989.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,989.57
|
| Rate for Payer: Multiplan Commercial |
$8,520.75
|
| Rate for Payer: Multiplan WC |
$12,632.22
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,721.05
|
| Rate for Payer: TriValley Medical Group Senior |
$8,721.05
|
| 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 |
$11,892.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,721.05
|
| Rate for Payer: Vantage Medical Group Senior |
$7,928.23
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
IP
|
$3,265.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.97 |
| Max. Negotiated Rate |
$2,448.75 |
| Rate for Payer: Adventist Health Commercial |
$653.00
|
| Rate for Payer: Cash Price |
$1,795.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,210.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,210.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$816.25
|
| Rate for Payer: Multiplan Commercial |
$2,448.75
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
OP
|
$3,265.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$653.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,243.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$1,795.75
|
| Rate for Payer: Cash Price |
$1,795.75
|
| Rate for Payer: Cash Price |
$1,795.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,122.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,021.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$549.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,263.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$816.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$2,448.75
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,310.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
IP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$200.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.04
|
| Rate for Payer: Blue Shield of California EPN |
$168.04
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$192.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$193.53
|
| Rate for Payer: Heritage Provider Network Senior |
$193.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$209.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.50
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.40
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
OP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$200.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$287.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.04
|
| Rate for Payer: Blue Shield of California EPN |
$168.04
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$192.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$355.30
|
| Rate for Payer: Dignity Health Senior |
$355.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$193.53
|
| Rate for Payer: Heritage Provider Network Senior |
$193.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$209.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$292.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$292.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$355.30
|
| Rate for Payer: Vantage Medical Group Senior |
$355.30
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
IP
|
$21,927.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,968.79 |
| Max. Negotiated Rate |
$16,445.25 |
| Rate for Payer: Adventist Health Commercial |
$4,385.40
|
| Rate for Payer: Cash Price |
$12,059.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,844.58
|
| Rate for Payer: Heritage Provider Network Senior |
$14,844.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,481.75
|
| Rate for Payer: Multiplan Commercial |
$16,445.25
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
OP
|
$21,927.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,134.15 |
| Rate for Payer: Adventist Health Commercial |
$4,385.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,063.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,228.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$12,059.85
|
| Rate for Payer: Cash Price |
$12,059.85
|
| Rate for Payer: Cash Price |
$12,059.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,252.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,551.35
|
| Rate for Payer: Dignity Health Senior |
$13,228.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,228.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,572.81
|
| Rate for Payer: Heritage Provider Network Senior |
$16,271.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,228.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,134.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,212.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,481.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,667.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,667.91
|
| Rate for Payer: Multiplan Commercial |
$16,445.25
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,551.35
|
| Rate for Payer: TriValley Medical Group Senior |
$14,551.35
|
| 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 |
$19,842.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Vantage Medical Group Senior |
$13,228.50
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
|
OP
|
$11,540.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$2,308.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,927.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| 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 |
$6,347.00
|
| Rate for Payer: Cash Price |
$6,347.00
|
| Rate for Payer: Cash Price |
$6,347.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,501.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,143.26
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$373.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,088.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,885.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$8,655.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
|
IP
|
$11,540.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,088.74 |
| Max. Negotiated Rate |
$8,655.00 |
| Rate for Payer: Adventist Health Commercial |
$2,308.00
|
| Rate for Payer: Cash Price |
$6,347.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,812.58
|
| Rate for Payer: Heritage Provider Network Senior |
$7,812.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,088.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,885.00
|
| Rate for Payer: Multiplan Commercial |
$8,655.00
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
IP
|
$9,577.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,733.44 |
| Max. Negotiated Rate |
$7,182.75 |
| Rate for Payer: Adventist Health Commercial |
$1,915.40
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,483.63
|
| Rate for Payer: Heritage Provider Network Senior |
$6,483.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,733.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,394.25
|
| Rate for Payer: Multiplan Commercial |
$7,182.75
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
OP
|
$9,577.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,915.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,579.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,225.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,483.63
|
| Rate for Payer: Heritage Provider Network Senior |
$6,483.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,568.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,733.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,394.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$7,182.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,445.80
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,170.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
IP
|
$9,577.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,733.44 |
| Max. Negotiated Rate |
$7,182.75 |
| Rate for Payer: Adventist Health Commercial |
$1,915.40
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,483.63
|
| Rate for Payer: Heritage Provider Network Senior |
$6,483.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,733.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,394.25
|
| Rate for Payer: Multiplan Commercial |
$7,182.75
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
OP
|
$9,577.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,915.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,579.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| 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 |
$5,267.35
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Cash Price |
$5,267.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,225.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,928.16
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,218.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,733.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,394.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$7,182.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
