|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
|
IP
|
$2,245.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$406.35 |
| Max. Negotiated Rate |
$1,683.75 |
| Rate for Payer: Adventist Health Commercial |
$449.00
|
| Rate for Payer: Cash Price |
$1,234.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,519.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,519.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$406.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.25
|
| Rate for Payer: Multiplan Commercial |
$1,683.75
|
|
|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
|
OP
|
$2,245.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$449.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,542.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,908.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,683.75
|
| 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 |
$1,234.75
|
| Rate for Payer: Cash Price |
$1,234.75
|
| Rate for Payer: Cash Price |
$1,234.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,459.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,908.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,908.25
|
| Rate for Payer: Dignity Health Senior |
$1,908.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,389.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,389.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,751.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,070.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$406.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,571.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,571.50
|
| Rate for Payer: Multiplan Commercial |
$1,683.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,908.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,908.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,908.25
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
|
IP
|
$6,261.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,133.24 |
| Max. Negotiated Rate |
$4,695.75 |
| Rate for Payer: Adventist Health Commercial |
$1,252.20
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,238.70
|
| Rate for Payer: Heritage Provider Network Senior |
$4,238.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,565.25
|
| Rate for Payer: Multiplan Commercial |
$4,695.75
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
|
OP
|
$6,261.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,252.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,301.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,321.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,443.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,695.75
|
| 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 |
$3,443.55
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,069.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,321.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,321.85
|
| Rate for Payer: Dignity Health Senior |
$5,321.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,875.56
|
| Rate for Payer: Heritage Provider Network Senior |
$3,875.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$208.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,986.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,565.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,382.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,382.70
|
| Rate for Payer: Multiplan Commercial |
$4,695.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,321.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,321.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5,321.85
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
|
OP
|
$7,200.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,440.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,946.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| 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 |
$3,960.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,680.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Senior |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,684.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,456.80
|
| Rate for Payer: Heritage Provider Network Senior |
$5,762.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,339.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,900.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,303.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,387.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,800.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,902.65
|
| Rate for Payer: Multiplan Commercial |
$5,400.00
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,153.10
|
| Rate for Payer: TriValley Medical Group Senior |
$5,153.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
|
IP
|
$7,200.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,303.20 |
| Max. Negotiated Rate |
$5,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,440.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,874.40
|
| Rate for Payer: Heritage Provider Network Senior |
$4,874.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,303.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,800.00
|
| Rate for Payer: Multiplan Commercial |
$5,400.00
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
|
OP
|
$6,261.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,252.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,301.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| 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 |
$3,443.55
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,069.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Senior |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,684.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,875.56
|
| Rate for Payer: Heritage Provider Network Senior |
$5,762.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,422.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,900.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,387.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,565.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,902.65
|
| Rate for Payer: Multiplan Commercial |
$4,695.75
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,153.10
|
| Rate for Payer: TriValley Medical Group Senior |
$5,153.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
|
IP
|
$6,261.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,133.24 |
| Max. Negotiated Rate |
$4,695.75 |
| Rate for Payer: Adventist Health Commercial |
$1,252.20
|
| Rate for Payer: Cash Price |
$3,443.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,238.70
|
| Rate for Payer: Heritage Provider Network Senior |
$4,238.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,565.25
|
| Rate for Payer: Multiplan Commercial |
$4,695.75
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$4,072.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$737.03 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,756.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,756.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$4,072.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,797.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,483.92
|
| Rate for Payer: Blue Shield of California EPN |
$1,987.14
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Senior |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,191.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,520.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,520.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$337.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,942.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,519.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,760.80
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,410.22
|
| Rate for Payer: TriValley Medical Group Senior |
$2,410.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,036.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,036.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
OP
|
$13,419.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$16,711.81 |
| Rate for Payer: Adventist Health Commercial |
$2,683.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,218.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,722.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Senior |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,795.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,306.36
|
| Rate for Payer: Heritage Provider Network Senior |
$10,818.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$302.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,711.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,428.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,115.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,354.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,082.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,082.57
|
| Rate for Payer: Multiplan Commercial |
$10,064.25
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,675.26
|
| Rate for Payer: TriValley Medical Group Senior |
$9,675.26
|
| 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 |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
IP
|
$13,419.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,428.84 |
| Max. Negotiated Rate |
$10,064.25 |
| Rate for Payer: Adventist Health Commercial |
$2,683.80
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,084.66
|
| Rate for Payer: Heritage Provider Network Senior |
$9,084.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,428.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,354.75
|
| Rate for Payer: Multiplan Commercial |
$10,064.25
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
IP
|
$13,419.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,428.84 |
| Max. Negotiated Rate |
$10,064.25 |
| Rate for Payer: Adventist Health Commercial |
$2,683.80
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,084.66
|
| Rate for Payer: Heritage Provider Network Senior |
$9,084.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,428.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,354.75
|
| Rate for Payer: Multiplan Commercial |
$10,064.25
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
OP
|
$13,419.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$16,711.81 |
| Rate for Payer: Adventist Health Commercial |
$2,683.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,218.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cash Price |
$7,380.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,722.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Senior |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,795.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,306.36
|
| Rate for Payer: Heritage Provider Network Senior |
$10,818.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$318.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,711.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,428.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,115.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,354.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,082.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,082.57
|
| Rate for Payer: Multiplan Commercial |
$10,064.25
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,675.26
|
| Rate for Payer: TriValley Medical Group Senior |
$9,675.26
|
| 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 |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.54 |
| Max. Negotiated Rate |
$664.70 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$417.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$537.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Blue Shield of California Commercial |
$477.02
|
| Rate for Payer: Blue Shield of California EPN |
$381.62
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$508.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Senior |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$508.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$484.06
|
| Rate for Payer: Heritage Provider Network Senior |
$484.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$373.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$391.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.54 |
| Max. Negotiated Rate |
$586.50 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$529.41
|
| Rate for Payer: Heritage Provider Network Senior |
$529.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.50
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.54 |
| Max. Negotiated Rate |
$586.50 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$529.41
|
| Rate for Payer: Heritage Provider Network Senior |
$529.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.50
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.54 |
| Max. Negotiated Rate |
$664.70 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$417.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$537.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Blue Shield of California Commercial |
$477.02
|
| Rate for Payer: Blue Shield of California EPN |
$381.62
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$508.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Senior |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$508.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$484.06
|
| Rate for Payer: Heritage Provider Network Senior |
$484.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$373.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$391.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
OP
|
$4,072.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,797.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| 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 |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Senior |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,191.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,520.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,695.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$345.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,163.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,519.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,760.80
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,410.22
|
| Rate for Payer: TriValley Medical Group Senior |
$2,410.22
|
| 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 |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
IP
|
$4,072.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.03 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,756.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,756.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
OP
|
$4,072.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,797.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Senior |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,191.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,756.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,756.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,942.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,519.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,760.80
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,465.11
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,348.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
IP
|
$4,072.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$737.03 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Adventist Health Commercial |
$814.40
|
| Rate for Payer: Cash Price |
$2,239.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,756.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,756.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$737.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,018.00
|
| Rate for Payer: Multiplan Commercial |
$3,054.00
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
IP
|
$5,488.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$993.33 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Adventist Health Commercial |
$1,097.60
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,715.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3,715.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$993.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,372.00
|
| Rate for Payer: Multiplan Commercial |
$4,116.00
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
OP
|
$5,488.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,097.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,770.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,347.68
|
| Rate for Payer: Blue Shield of California EPN |
$2,678.14
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,567.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Senior |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,191.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,397.07
|
| Rate for Payer: Heritage Provider Network Senior |
$3,397.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$291.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,617.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$993.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,519.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,372.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,760.80
|
| Rate for Payer: Multiplan Commercial |
$4,116.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,410.22
|
| Rate for Payer: TriValley Medical Group Senior |
$2,410.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,744.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,744.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
OP
|
$5,986.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,197.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,112.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,088.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,292.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,489.50
|
| 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 |
$3,292.30
|
| Rate for Payer: Cash Price |
$3,292.30
|
| Rate for Payer: Cash Price |
$3,292.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,890.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,088.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,088.10
|
| Rate for Payer: Dignity Health Senior |
$5,088.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,705.33
|
| Rate for Payer: Heritage Provider Network Senior |
$3,705.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$106.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,855.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,083.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,496.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,190.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,190.20
|
| Rate for Payer: Multiplan Commercial |
$4,489.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,088.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,088.10
|
| Rate for Payer: Vantage Medical Group Senior |
$5,088.10
|
|
