|
HC BONE MARROW IMAGING, LTD
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$151.06 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$693.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$891.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Blue Shield of California Commercial |
$429.41
|
| Rate for Payer: Blue Shield of California EPN |
$345.32
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$843.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Senior |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$843.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$510.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$802.84
|
| Rate for Payer: Heritage Provider Network Senior |
$802.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$151.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$618.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.32
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$561.63
|
| Rate for Payer: TriValley Medical Group Senior |
$510.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$648.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$648.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$234.76 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$878.07
|
| Rate for Payer: Heritage Provider Network Senior |
$878.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.25
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
IP
|
$1,647.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$298.11 |
| Max. Negotiated Rate |
$1,235.25 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,115.02
|
| Rate for Payer: Heritage Provider Network Senior |
$1,115.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$298.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$411.75
|
| Rate for Payer: Multiplan Commercial |
$1,235.25
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
OP
|
$1,647.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$131.07 |
| Max. Negotiated Rate |
$1,235.25 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$880.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,131.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Blue Shield of California Commercial |
$525.22
|
| Rate for Payer: Blue Shield of California EPN |
$422.36
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Cash Price |
$905.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,070.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Senior |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,070.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$510.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,019.49
|
| Rate for Payer: Heritage Provider Network Senior |
$1,019.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$131.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$785.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$298.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$411.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.32
|
| Rate for Payer: Multiplan Commercial |
$1,235.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$561.63
|
| Rate for Payer: TriValley Medical Group Senior |
$510.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$823.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$823.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
OP
|
$2,563.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$228.47 |
| Max. Negotiated Rate |
$1,922.25 |
| Rate for Payer: Adventist Health Commercial |
$512.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,369.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,760.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Blue Shield of California Commercial |
$898.37
|
| Rate for Payer: Blue Shield of California EPN |
$722.44
|
| Rate for Payer: Cash Price |
$1,409.65
|
| Rate for Payer: Cash Price |
$1,409.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,665.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Senior |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,665.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$510.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,586.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,586.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$228.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,222.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$463.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.32
|
| Rate for Payer: Multiplan Commercial |
$1,922.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$561.63
|
| Rate for Payer: TriValley Medical Group Senior |
$510.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,281.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,281.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
IP
|
$2,563.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$463.90 |
| Max. Negotiated Rate |
$1,922.25 |
| Rate for Payer: Adventist Health Commercial |
$512.60
|
| Rate for Payer: Cash Price |
$1,409.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,735.15
|
| Rate for Payer: Heritage Provider Network Senior |
$1,735.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$463.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.75
|
| Rate for Payer: Multiplan Commercial |
$1,922.25
|
|
|
HC BONE SPECT
|
Facility
|
IP
|
$2,901.00
|
|
|
Service Code
|
CPT 78320
|
| Hospital Charge Code |
909301369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$525.08 |
| Max. Negotiated Rate |
$2,175.75 |
| Rate for Payer: Adventist Health Commercial |
$580.20
|
| Rate for Payer: Cash Price |
$1,595.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,963.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,963.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.25
|
| Rate for Payer: Multiplan Commercial |
$2,175.75
|
|
|
HC BONE SPECT
|
Facility
|
OP
|
$2,901.00
|
|
|
Service Code
|
CPT 78320
|
| Hospital Charge Code |
909301369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$525.08 |
| Max. Negotiated Rate |
$2,465.85 |
| Rate for Payer: Adventist Health Commercial |
$580.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,550.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,992.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,465.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,595.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,175.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,769.61
|
| Rate for Payer: Blue Shield of California EPN |
$1,415.69
|
| Rate for Payer: Cash Price |
$1,595.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,885.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,465.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,465.85
|
| Rate for Payer: Dignity Health Senior |
$2,465.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,885.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,795.72
|
| Rate for Payer: Heritage Provider Network Senior |
$1,795.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,383.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,030.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,030.70
|
| Rate for Payer: Multiplan Commercial |
$2,175.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,450.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,450.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,465.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,465.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,465.85
|
|
|
HC BONE SURVEY COMPLETE
|
Facility
|
OP
|
$2,158.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001600
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$1,618.50 |
| Rate for Payer: Adventist Health Commercial |
$431.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,153.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,482.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$376.89
|
| Rate for Payer: Blue Shield of California Commercial |
$411.50
|
| Rate for Payer: Blue Shield of California EPN |
$330.92
|
| Rate for Payer: Cash Price |
$1,186.90
|
| Rate for Payer: Cash Price |
$1,186.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,402.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,335.80
|
| Rate for Payer: Heritage Provider Network Senior |
$1,335.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$127.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,029.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,618.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC BONE SURVEY COMPLETE
|
Facility
|
IP
|
$2,158.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001600
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$390.60 |
| Max. Negotiated Rate |
$1,618.50 |
| Rate for Payer: Adventist Health Commercial |
$431.60
|
| Rate for Payer: Cash Price |
$1,186.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,460.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,460.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.50
|
| Rate for Payer: Multiplan Commercial |
$1,618.50
|
|
|
HC BONE SURVEY INFANT
|
Facility
|
IP
|
$452.00
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
900077076
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$81.81 |
| Max. Negotiated Rate |
$339.00 |
| Rate for Payer: Adventist Health Commercial |
$90.40
|
| Rate for Payer: Cash Price |
$248.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$306.00
|
| Rate for Payer: Heritage Provider Network Senior |
$306.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.00
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
|
|
HC BONE SURVEY INFANT
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
900077076
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$81.81 |
| Max. Negotiated Rate |
$356.69 |
| Rate for Payer: Adventist Health Commercial |
$90.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$241.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$310.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.67
|
| Rate for Payer: Blue Shield of California Commercial |
$356.69
|
| Rate for Payer: Blue Shield of California EPN |
$286.84
|
| Rate for Payer: Cash Price |
$248.60
|
| Rate for Payer: Cash Price |
$248.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$293.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$279.79
|
| Rate for Payer: Heritage Provider Network Senior |
$279.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$103.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC BOTOX INJECTION
|
Facility
|
IP
|
$2,998.00
|
|
|
Service Code
|
CPT 43236
|
| Hospital Charge Code |
906764999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$542.64 |
| Max. Negotiated Rate |
$2,248.50 |
| Rate for Payer: Adventist Health Commercial |
$599.60
|
| Rate for Payer: Cash Price |
$1,648.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,029.65
|
| Rate for Payer: Heritage Provider Network Senior |
$2,029.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$749.50
|
| Rate for Payer: Multiplan Commercial |
$2,248.50
|
|
|
HC BOTOX INJECTION
|
Facility
|
OP
|
$2,998.00
|
|
|
Service Code
|
CPT 43236
|
| Hospital Charge Code |
906764999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$599.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,059.63
|
| 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 |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,648.90
|
| Rate for Payer: Cash Price |
$1,648.90
|
| Rate for Payer: Cash Price |
$1,648.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,948.70
|
| 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 |
$1,855.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$393.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,430.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$542.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$749.50
|
| 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 |
$2,248.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$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 BOTOX INJECT SALIVARY GLAND
|
Facility
|
IP
|
$3,217.00
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
909020109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$582.28 |
| Max. Negotiated Rate |
$2,412.75 |
| Rate for Payer: Adventist Health Commercial |
$643.40
|
| Rate for Payer: Cash Price |
$1,769.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,177.91
|
| Rate for Payer: Heritage Provider Network Senior |
$2,177.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$804.25
|
| Rate for Payer: Multiplan Commercial |
$2,412.75
|
|
|
HC BOTOX INJECT SALIVARY GLAND
|
Facility
|
OP
|
$3,217.00
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
909020109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$643.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,210.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,769.35
|
| Rate for Payer: Cash Price |
$1,769.35
|
| Rate for Payer: Cash Price |
$1,769.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,091.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Senior |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,930.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$375.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,991.32
|
| Rate for Payer: Heritage Provider Network Senior |
$461.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$139.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$712.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$431.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$804.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$472.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$472.59
|
| Rate for Payer: Multiplan Commercial |
$2,412.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: TriValley Medical Group Commercial |
$412.58
|
| Rate for Payer: TriValley Medical Group Senior |
$412.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC BRAF
|
Facility
|
OP
|
$519.00
|
|
|
Service Code
|
CPT 81210
|
| Hospital Charge Code |
903800312
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$443.21 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$277.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$356.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$263.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$443.21
|
| Rate for Payer: Blue Shield of California Commercial |
$316.59
|
| Rate for Payer: Blue Shield of California EPN |
$253.27
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$337.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$263.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$192.94
|
| Rate for Payer: Dignity Health Senior |
$175.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$175.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$321.26
|
| Rate for Payer: Heritage Provider Network Senior |
$321.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$126.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$175.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$247.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$201.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$221.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.40
|
| Rate for Payer: TriValley Medical Group Senior |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$189.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$189.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$263.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$192.94
|
| Rate for Payer: Vantage Medical Group Senior |
$175.40
|
|
|
HC BRAF
|
Facility
|
IP
|
$519.00
|
|
|
Service Code
|
CPT 81210
|
| Hospital Charge Code |
903800312
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$389.25 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$351.36
|
| Rate for Payer: Heritage Provider Network Senior |
$351.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.75
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
|
|
HC BRAF PACKAGE
|
Facility
|
IP
|
$519.00
|
|
|
Service Code
|
CPT 81210
|
| Hospital Charge Code |
903800313
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$389.25 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$351.36
|
| Rate for Payer: Heritage Provider Network Senior |
$351.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.75
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
|
|
HC BRAF PACKAGE
|
Facility
|
OP
|
$519.00
|
|
|
Service Code
|
CPT 81210
|
| Hospital Charge Code |
903800313
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$443.21 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$277.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$356.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$263.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$443.21
|
| Rate for Payer: Blue Shield of California Commercial |
$316.59
|
| Rate for Payer: Blue Shield of California EPN |
$253.27
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Cash Price |
$285.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$337.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$263.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$192.94
|
| Rate for Payer: Dignity Health Senior |
$175.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$175.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$321.26
|
| Rate for Payer: Heritage Provider Network Senior |
$321.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$126.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$175.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$247.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$201.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$221.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.40
|
| Rate for Payer: TriValley Medical Group Senior |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$189.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$189.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$263.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$192.94
|
| Rate for Payer: Vantage Medical Group Senior |
$175.40
|
|
|
HC BRAIN IMAGE 4+ VIEWS
|
Facility
|
IP
|
$1,259.00
|
|
|
Service Code
|
CPT 78605
|
| Hospital Charge Code |
909301410
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$227.88 |
| Max. Negotiated Rate |
$944.25 |
| Rate for Payer: Adventist Health Commercial |
$251.80
|
| Rate for Payer: Cash Price |
$692.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$852.34
|
| Rate for Payer: Heritage Provider Network Senior |
$852.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.75
|
| Rate for Payer: Multiplan Commercial |
$944.25
|
|
|
HC BRAIN IMAGE 4+ VIEWS
|
Facility
|
OP
|
$1,259.00
|
|
|
Service Code
|
CPT 78605
|
| Hospital Charge Code |
909301410
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$217.27 |
| Max. Negotiated Rate |
$1,025.89 |
| Rate for Payer: Adventist Health Commercial |
$251.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$672.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$864.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Blue Shield of California Commercial |
$714.82
|
| Rate for Payer: Blue Shield of California EPN |
$574.83
|
| Rate for Payer: Cash Price |
$692.45
|
| Rate for Payer: Cash Price |
$692.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$818.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Senior |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$818.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$683.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$779.32
|
| Rate for Payer: Heritage Provider Network Senior |
$779.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$217.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$600.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$786.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$861.75
|
| Rate for Payer: Multiplan Commercial |
$944.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$752.32
|
| Rate for Payer: TriValley Medical Group Senior |
$683.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$629.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$629.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC BRAIN IMAGE 4+ VIEWS W FLOW
|
Facility
|
IP
|
$1,887.00
|
|
|
Service Code
|
CPT 78606
|
| Hospital Charge Code |
909301411
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$341.55 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: Adventist Health Commercial |
$377.40
|
| Rate for Payer: Cash Price |
$1,037.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,277.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,277.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.75
|
| Rate for Payer: Multiplan Commercial |
$1,415.25
|
|
|
HC BRAIN IMAGE 4+ VIEWS W FLOW
|
Facility
|
OP
|
$1,887.00
|
|
|
Service Code
|
CPT 78606
|
| Hospital Charge Code |
909301411
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$257.87 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: Adventist Health Commercial |
$377.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,008.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,296.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Blue Shield of California Commercial |
$814.08
|
| Rate for Payer: Blue Shield of California EPN |
$654.66
|
| Rate for Payer: Cash Price |
$1,037.85
|
| Rate for Payer: Cash Price |
$1,037.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,226.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Senior |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,226.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$683.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,168.05
|
| Rate for Payer: Heritage Provider Network Senior |
$1,168.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$257.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$900.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$786.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$861.75
|
| Rate for Payer: Multiplan Commercial |
$1,415.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$752.32
|
| Rate for Payer: TriValley Medical Group Senior |
$683.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$943.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$943.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC BRAIN IMAGING (3D)
|
Facility
|
OP
|
$3,226.00
|
|
|
Service Code
|
CPT 78607
|
| Hospital Charge Code |
909301409
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$583.91 |
| Max. Negotiated Rate |
$2,742.10 |
| Rate for Payer: Adventist Health Commercial |
$645.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,724.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,216.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,742.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,774.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,419.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,967.86
|
| Rate for Payer: Blue Shield of California EPN |
$1,574.29
|
| Rate for Payer: Cash Price |
$1,774.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,096.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,742.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,742.10
|
| Rate for Payer: Dignity Health Senior |
$2,742.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,096.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,996.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1,996.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,538.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$583.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$806.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,258.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,258.20
|
| Rate for Payer: Multiplan Commercial |
$2,419.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,613.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,613.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,742.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,742.10
|
| Rate for Payer: Vantage Medical Group Senior |
$2,742.10
|
|
