|
HC BLOOD DRAW FOR VAD
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
901200031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.04 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$56.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$150.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$193.73
|
| 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 |
$1,915.00
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$183.30
|
| 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 |
$190.91
|
| Rate for Payer: Heritage Provider Network Senior |
$190.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$134.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.50
|
| 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 |
$211.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$101.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$93.37
|
| 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 BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$44.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.40
|
| Rate for Payer: Dignity Health Senior |
$71.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.87
|
| Rate for Payer: Heritage Provider Network Senior |
$56.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$30.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.40
|
| Rate for Payer: Vantage Medical Group Senior |
$71.40
|
|
|
HC BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.87
|
| Rate for Payer: Heritage Provider Network Senior |
$56.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
|
|
HC BLOOD GAS AND COOXIMETRY
|
Facility
|
OP
|
$1,571.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900801109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.37 |
| Max. Negotiated Rate |
$1,178.25 |
| Rate for Payer: Adventist Health Commercial |
$314.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$839.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,079.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.67
|
| Rate for Payer: Blue Shield of California Commercial |
$228.38
|
| Rate for Payer: Blue Shield of California EPN |
$183.18
|
| Rate for Payer: Cash Price |
$864.05
|
| Rate for Payer: Cash Price |
$864.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,021.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.65
|
| Rate for Payer: Dignity Health Senior |
$78.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,021.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$78.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$972.45
|
| Rate for Payer: Heritage Provider Network Senior |
$972.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$749.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$284.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99.25
|
| Rate for Payer: Multiplan Commercial |
$1,178.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$78.77
|
| Rate for Payer: TriValley Medical Group Senior |
$78.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$85.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$85.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Vantage Medical Group Senior |
$78.77
|
|
|
HC BLOOD GAS AND COOXIMETRY
|
Facility
|
IP
|
$1,571.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900801109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$284.35 |
| Max. Negotiated Rate |
$1,178.25 |
| Rate for Payer: Adventist Health Commercial |
$314.20
|
| Rate for Payer: Cash Price |
$864.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,063.57
|
| Rate for Payer: Heritage Provider Network Senior |
$1,063.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$284.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.75
|
| Rate for Payer: Multiplan Commercial |
$1,178.25
|
|
|
HC BLOOD GAS CHLORIDE
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900801121
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.08 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.59
|
| Rate for Payer: Heritage Provider Network Senior |
$82.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
|
|
HC BLOOD GAS CHLORIDE
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900801121
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$65.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$83.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.35
|
| Rate for Payer: Blue Shield of California Commercial |
$36.98
|
| Rate for Payer: Blue Shield of California EPN |
$29.66
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$79.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.06
|
| Rate for Payer: Dignity Health Senior |
$4.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.52
|
| Rate for Payer: Heritage Provider Network Senior |
$75.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$58.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.80
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.60
|
| Rate for Payer: TriValley Medical Group Senior |
$4.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Vantage Medical Group Senior |
$4.60
|
|
|
HC BLOOD GASES CH
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900912188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
|
|
HC BLOOD GASES CH
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900912188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$256.67 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.67
|
| Rate for Payer: Blue Shield of California Commercial |
$228.38
|
| Rate for Payer: Blue Shield of California EPN |
$183.18
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.65
|
| Rate for Payer: Dignity Health Senior |
$78.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$78.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99.25
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$78.77
|
| Rate for Payer: TriValley Medical Group Senior |
$78.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$85.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$85.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Vantage Medical Group Senior |
$78.77
|
|
|
HC BLOOD GAS POTASSIUM
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
900801122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$65.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$83.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.35
|
| Rate for Payer: Blue Shield of California Commercial |
$36.98
|
| Rate for Payer: Blue Shield of California EPN |
$29.66
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$79.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.24
|
| Rate for Payer: Dignity Health Senior |
$4.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.52
|
| Rate for Payer: Heritage Provider Network Senior |
$75.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$58.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.76
|
| Rate for Payer: TriValley Medical Group Senior |
$4.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.24
|
| Rate for Payer: Vantage Medical Group Senior |
$4.76
|
|
|
HC BLOOD GAS POTASSIUM
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
900801122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.08 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.59
|
| Rate for Payer: Heritage Provider Network Senior |
$82.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
|
|
HC BLOOD GAS SODIUM
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900801123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$65.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$83.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.76
|
| Rate for Payer: Blue Shield of California Commercial |
$38.71
|
| Rate for Payer: Blue Shield of California EPN |
$31.05
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$79.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.29
|
| Rate for Payer: Dignity Health Senior |
$4.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.52
|
| Rate for Payer: Heritage Provider Network Senior |
$75.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$58.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.06
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.81
|
| Rate for Payer: TriValley Medical Group Senior |
$4.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC BLOOD GAS SODIUM
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
900801123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.08 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.59
|
| Rate for Payer: Heritage Provider Network Senior |
$82.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.50
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
|
|
HC BLOOD OCCULT FECES
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
900911638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$127.99 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$72.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.93
|
| Rate for Payer: Blue Shield of California Commercial |
$127.99
|
| Rate for Payer: Blue Shield of California EPN |
$102.66
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.51
|
| Rate for Payer: Dignity Health Senior |
$15.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.56
|
| Rate for Payer: Heritage Provider Network Senior |
$83.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$64.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.06
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.92
|
| Rate for Payer: TriValley Medical Group Senior |
$15.92
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.51
|
| Rate for Payer: Vantage Medical Group Senior |
$15.92
|
|
|
HC BLOOD OCCULT FECES
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
900911638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.43 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$91.39
|
| Rate for Payer: Heritage Provider Network Senior |
$91.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
|
|
HC BLOOD PH PCO2 P02 (POC)
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
900912112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Adventist Health Commercial |
$50.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$134.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$172.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.64
|
| Rate for Payer: Blue Shield of California Commercial |
$155.75
|
| Rate for Payer: Blue Shield of California EPN |
$124.92
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$163.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Senior |
$26.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$26.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$155.37
|
| Rate for Payer: Heritage Provider Network Senior |
$155.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$119.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$188.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$26.07
|
| Rate for Payer: TriValley Medical Group Senior |
$26.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$28.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC BLOOD PH PCO2 P02 (POC)
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
900912112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.43 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Adventist Health Commercial |
$50.20
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$169.93
|
| Rate for Payer: Heritage Provider Network Senior |
$169.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.75
|
| Rate for Payer: Multiplan Commercial |
$188.25
|
|
|
HC BLOOD/PLASMA VOLUME
|
Facility
|
OP
|
$1,311.00
|
|
|
Service Code
|
CPT 78111
|
| Hospital Charge Code |
909301331
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$84.90 |
| Max. Negotiated Rate |
$2,488.11 |
| Rate for Payer: Adventist Health Commercial |
$262.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$700.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$900.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Blue Shield of California Commercial |
$543.41
|
| Rate for Payer: Blue Shield of California EPN |
$436.99
|
| Rate for Payer: Cash Price |
$721.05
|
| Rate for Payer: Cash Price |
$721.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$852.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Senior |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$852.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,658.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$811.51
|
| Rate for Payer: Heritage Provider Network Senior |
$811.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$625.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,907.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,090.01
|
| Rate for Payer: Multiplan Commercial |
$983.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,824.61
|
| Rate for Payer: TriValley Medical Group Senior |
$1,658.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$655.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$655.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC BLOOD/PLASMA VOLUME
|
Facility
|
IP
|
$1,311.00
|
|
|
Service Code
|
CPT 78111
|
| Hospital Charge Code |
909301331
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$237.29 |
| Max. Negotiated Rate |
$983.25 |
| Rate for Payer: Adventist Health Commercial |
$262.20
|
| Rate for Payer: Cash Price |
$721.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$887.55
|
| Rate for Payer: Heritage Provider Network Senior |
$887.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.75
|
| Rate for Payer: Multiplan Commercial |
$983.25
|
|
|
HC BODY FLUID LIPD ANAL ELECT TECH
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 82664
|
| Hospital Charge Code |
900913920
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$276.48 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$44.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$92.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.26
|
| Rate for Payer: Blue Shield of California Commercial |
$276.48
|
| Rate for Payer: Blue Shield of California EPN |
$221.76
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$92.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.65
|
| Rate for Payer: Dignity Health Senior |
$61.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$61.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.49
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$61.50
|
| Rate for Payer: TriValley Medical Group Senior |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$66.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$92.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Vantage Medical Group Senior |
$61.50
|
|
|
HC BODY FLUID LIPD ANAL ELECT TECH
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 82664
|
| Hospital Charge Code |
900913920
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.87
|
| Rate for Payer: Heritage Provider Network Senior |
$56.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
|
|
HC BODY FLUID LIPD ANAL SPEC ANLYT
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900913918
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$63.86 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.86
|
| Rate for Payer: Blue Shield of California Commercial |
$56.28
|
| Rate for Payer: Blue Shield of California EPN |
$45.14
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.91
|
| Rate for Payer: Dignity Health Senior |
$8.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.67
|
| Rate for Payer: Heritage Provider Network Senior |
$8.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.21
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.10
|
| Rate for Payer: TriValley Medical Group Senior |
$8.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC BODY FLUID LIPD ANAL SPEC ANLYT
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900913918
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.48
|
| Rate for Payer: Heritage Provider Network Senior |
$9.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$333.75 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$301.26
|
| Rate for Payer: Heritage Provider Network Senior |
$301.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$445.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$378.25 |
| Rate for Payer: Adventist Health Commercial |
$182.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$237.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$305.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$244.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$333.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Cash Price |
$244.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$289.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$378.25
|
| Rate for Payer: Dignity Health Senior |
$378.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$275.45
|
| Rate for Payer: Heritage Provider Network Senior |
$275.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$212.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.50
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$378.25
|
| Rate for Payer: Vantage Medical Group Senior |
$378.25
|
|
