|
HC ANTINUCLEAR ANTIBODIES (ANA)
|
Facility
IP
|
$169.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900910969
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.59 |
| Max. Negotiated Rate |
$126.75 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$116.10
|
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$114.41
|
| Rate for Payer: Heritage Provider Network Senior |
$114.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.25
|
| Rate for Payer: Multiplan Commercial |
$126.75
|
|
|
HC ANTINUCLEAR ANTIBODIES (ANA)
|
Facility
OP
|
$36.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900910969
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$101.15 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.15
|
| Rate for Payer: Blue Shield of California Commercial |
$94.42
|
| Rate for Payer: Blue Shield of California EPN |
$73.81
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.30
|
| Rate for Payer: Dignity Health Senior |
$12.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.28
|
| Rate for Payer: Heritage Provider Network Senior |
$22.28
|
| Rate for Payer: Humana Medicare |
$12.09
|
| Rate for Payer: IEHP Medi-Cal |
$16.58
|
| Rate for Payer: IEHP Medicare Advantage |
$12.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.23
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.09
|
| Rate for Payer: TriValley Medical Group Senior |
$12.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Vantage Medical Group Senior |
$12.09
|
|
|
HC ANTISTREPTOLYSIN O
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900910881
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$113.94 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.94
|
| Rate for Payer: Blue Shield of California Commercial |
$106.21
|
| Rate for Payer: Blue Shield of California EPN |
$83.03
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.96
|
| Rate for Payer: Dignity Health Senior |
$13.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$13.60
|
| Rate for Payer: IEHP Medi-Cal |
$18.86
|
| Rate for Payer: IEHP Medicare Advantage |
$13.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.14
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Senior |
$13.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
|
|
HC ANTISTREPTOLYSIN O
|
Facility
IP
|
$168.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900910881
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Adventist Health Commercial |
$33.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$115.42
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$113.74
|
| Rate for Payer: Heritage Provider Network Senior |
$113.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$126.00
|
|
|
HC ANTITHROMBIN III ACTIVITY
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
900912010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$99.18 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$34.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.18
|
| Rate for Payer: Blue Shield of California Commercial |
$92.51
|
| Rate for Payer: Blue Shield of California EPN |
$72.32
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.04
|
| Rate for Payer: Dignity Health Senior |
$11.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$11.85
|
| Rate for Payer: IEHP Medi-Cal |
$16.33
|
| Rate for Payer: IEHP Medicare Advantage |
$11.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.93
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.85
|
| Rate for Payer: TriValley Medical Group Senior |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.80
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC ANTITHROMBIN III ACTIVITY
|
Facility
IP
|
$330.00
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
900912010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.73 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Adventist Health Commercial |
$66.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$226.71
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$223.41
|
| Rate for Payer: Heritage Provider Network Senior |
$223.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.50
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
OP
|
$41.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
900912011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$90.50 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.50
|
| Rate for Payer: Blue Shield of California Commercial |
$84.46
|
| Rate for Payer: Blue Shield of California EPN |
$66.03
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.89
|
| Rate for Payer: Dignity Health Senior |
$10.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$25.38
|
| Rate for Payer: Heritage Provider Network Senior |
$25.38
|
| Rate for Payer: Humana Medicare |
$10.81
|
| Rate for Payer: IEHP Medi-Cal |
$14.99
|
| Rate for Payer: IEHP Medicare Advantage |
$10.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.62
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.81
|
| Rate for Payer: TriValley Medical Group Senior |
$10.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: Vantage Medical Group Senior |
$10.81
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
IP
|
$330.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
900912011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.73 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Adventist Health Commercial |
$66.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$226.71
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$223.41
|
| Rate for Payer: Heritage Provider Network Senior |
$223.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.50
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
|
|
HC ANTI-XA APIXABAN
|
Facility
IP
|
$34.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.15 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23.36
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.02
|
| Rate for Payer: Heritage Provider Network Senior |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
|
|
HC ANTI-XA APIXABAN
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$102.24 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.09
|
| Rate for Payer: Blue Shield of California Commercial |
$102.24
|
| Rate for Payer: Blue Shield of California EPN |
$79.93
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Senior |
$13.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.48
|
| Rate for Payer: Heritage Provider Network Senior |
$15.48
|
| Rate for Payer: Humana Medicare |
$13.09
|
| Rate for Payer: IEHP Medi-Cal |
$17.89
|
| Rate for Payer: IEHP Medicare Advantage |
$13.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.49
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.09
|
| Rate for Payer: TriValley Medical Group Senior |
$13.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
OP
|
$73.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$102.24 |
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.09
|
| Rate for Payer: Blue Shield of California Commercial |
$102.24
|
| Rate for Payer: Blue Shield of California EPN |
$79.93
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$47.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Senior |
$13.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.19
|
| Rate for Payer: Heritage Provider Network Senior |
$45.19
|
| Rate for Payer: Humana Medicare |
$13.09
|
| Rate for Payer: IEHP Medi-Cal |
$17.89
|
| Rate for Payer: IEHP Medicare Advantage |
$13.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.49
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.09
|
| Rate for Payer: TriValley Medical Group Senior |
$13.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
IP
|
$129.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Adventist Health Commercial |
$25.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$88.62
|
| Rate for Payer: Cash Price |
$58.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$87.33
|
| Rate for Payer: Heritage Provider Network Senior |
$87.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.25
|
| Rate for Payer: Multiplan Commercial |
$96.75
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
OP
|
$1,870.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$374.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,284.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,589.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,028.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,402.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,215.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,589.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,589.50
|
| Rate for Payer: Dignity Health Senior |
$1,589.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,157.53
|
| Rate for Payer: Heritage Provider Network Senior |
$1,157.53
|
| Rate for Payer: IEHP Medi-Cal |
$232.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$901.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.50
|
| Rate for Payer: Multiplan Commercial |
$1,402.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,589.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,589.50
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
IP
|
$1,870.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$338.47 |
| Max. Negotiated Rate |
$1,402.50 |
| Rate for Payer: Adventist Health Commercial |
$374.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,284.69
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,265.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,265.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.50
|
| Rate for Payer: Multiplan Commercial |
$1,402.50
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
IP
|
$1,416.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
906820175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.30 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Adventist Health Commercial |
$283.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$972.79
|
| Rate for Payer: Cash Price |
$637.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$958.63
|
| Rate for Payer: Heritage Provider Network Senior |
$958.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$256.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.00
|
| Rate for Payer: Multiplan Commercial |
$1,062.00
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
OP
|
$1,416.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
906820175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$283.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$972.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,203.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$778.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,062.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$637.20
|
| Rate for Payer: Cash Price |
$637.20
|
| Rate for Payer: Cash Price |
$637.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$920.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,203.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,203.60
|
| Rate for Payer: Dignity Health Senior |
$1,203.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$876.50
|
| Rate for Payer: Heritage Provider Network Senior |
$876.50
|
| Rate for Payer: IEHP Medi-Cal |
$232.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$682.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$256.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.00
|
| Rate for Payer: Multiplan Commercial |
$1,062.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,203.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,203.60
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
IP
|
$1,761.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906811416
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$318.74 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$352.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,209.81
|
| Rate for Payer: Cash Price |
$792.45
|
| Rate for Payer: Cash Price |
$792.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$318.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.25
|
| Rate for Payer: Multiplan Commercial |
$1,320.75
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
OP
|
$1,761.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906811416
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$145.39 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$352.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7,402.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,209.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,496.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$968.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,320.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$792.45
|
| Rate for Payer: Cash Price |
$792.45
|
| Rate for Payer: Cash Price |
$792.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,496.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,496.85
|
| Rate for Payer: Dignity Health Senior |
$1,496.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,090.06
|
| Rate for Payer: Heritage Provider Network Senior |
$1,090.06
|
| Rate for Payer: IEHP Medi-Cal |
$145.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$848.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$318.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.25
|
| Rate for Payer: Multiplan Commercial |
$1,320.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,496.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,496.85
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
IP
|
$2,530.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906820073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$457.93 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$506.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,738.11
|
| Rate for Payer: Cash Price |
$1,138.50
|
| Rate for Payer: Cash Price |
$1,138.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.50
|
| Rate for Payer: Multiplan Commercial |
$1,897.50
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
OP
|
$2,530.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906820073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$145.39 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$506.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7,402.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,738.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,150.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,391.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,897.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$1,138.50
|
| Rate for Payer: Cash Price |
$1,138.50
|
| Rate for Payer: Cash Price |
$1,138.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,150.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,150.50
|
| Rate for Payer: Dignity Health Senior |
$2,150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,644.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,566.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,566.07
|
| Rate for Payer: IEHP Medi-Cal |
$145.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,219.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.50
|
| Rate for Payer: Multiplan Commercial |
$1,897.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,150.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,150.50
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
IP
|
$12,988.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
906820189
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,350.83 |
| Max. Negotiated Rate |
$9,741.00 |
| Rate for Payer: Adventist Health Commercial |
$2,597.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,922.76
|
| Rate for Payer: Cash Price |
$5,844.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,792.88
|
| Rate for Payer: Heritage Provider Network Senior |
$8,792.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,350.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,247.00
|
| Rate for Payer: Multiplan Commercial |
$9,741.00
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
OP
|
$12,988.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
906820189
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$179.37 |
| Max. Negotiated Rate |
$9,741.00 |
| Rate for Payer: Adventist Health Commercial |
$2,597.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$351.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,922.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$5,844.60
|
| Rate for Payer: Cash Price |
$5,844.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,442.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,442.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,039.57
|
| Rate for Payer: Heritage Provider Network Senior |
$8,039.57
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$179.37
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,350.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,247.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$9,741.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
OP
|
$7,382.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$179.37 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,476.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$351.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,071.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,321.90
|
| Rate for Payer: Cash Price |
$3,321.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,798.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,798.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,569.46
|
| Rate for Payer: Heritage Provider Network Senior |
$4,569.46
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$179.37
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,336.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,845.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,536.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
IP
|
$7,382.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,336.14 |
| Max. Negotiated Rate |
$5,536.50 |
| Rate for Payer: Adventist Health Commercial |
$1,476.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,071.43
|
| Rate for Payer: Cash Price |
$3,321.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,997.61
|
| Rate for Payer: Heritage Provider Network Senior |
$4,997.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,336.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,845.50
|
| Rate for Payer: Multiplan Commercial |
$5,536.50
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
OP
|
$7,382.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$221.86 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,476.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$360.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,071.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,127.65
|
| Rate for Payer: Blue Shield of California Commercial |
$2,679.45
|
| Rate for Payer: Blue Shield of California EPN |
$1,523.72
|
| Rate for Payer: Cash Price |
$3,321.90
|
| Rate for Payer: Cash Price |
$3,321.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,798.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,798.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,569.46
|
| Rate for Payer: Heritage Provider Network Senior |
$4,569.46
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$221.86
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,336.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,845.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,536.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
