|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
OP
|
$359.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$269.40 |
| Rate for Payer: Adventist Health Commercial |
$71.84
|
| Rate for Payer: Aetna of CA Gatekeeper |
$191.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$246.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.90
|
| Rate for Payer: Blue Shield of California Commercial |
$152.70
|
| Rate for Payer: Blue Shield of California EPN |
$122.48
|
| Rate for Payer: Cash Price |
$197.56
|
| Rate for Payer: Cash Price |
$197.56
|
| Rate for Payer: Cigna of CA HMO/PPO |
$233.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.86
|
| Rate for Payer: Dignity Health Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$222.34
|
| Rate for Payer: Heritage Provider Network Senior |
$222.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$171.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.89
|
| Rate for Payer: Multiplan Commercial |
$269.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.96
|
| Rate for Payer: TriValley Medical Group Senior |
$18.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
IP
|
$359.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$65.02 |
| Max. Negotiated Rate |
$269.40 |
| Rate for Payer: Adventist Health Commercial |
$71.84
|
| Rate for Payer: Cash Price |
$197.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$243.18
|
| Rate for Payer: Heritage Provider Network Senior |
$243.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.80
|
| Rate for Payer: Multiplan Commercial |
$269.40
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
OP
|
$2,360.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$1,770.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,024.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,621.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Blue Shield of California Commercial |
$346.85
|
| Rate for Payer: Blue Shield of California EPN |
$278.92
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$910.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Senior |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$453.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$573.00
|
| Rate for Payer: Heritage Provider Network Senior |
$521.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$473.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,125.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$521.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$590.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$571.75
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$225.00
|
| Rate for Payer: TriValley Medical Group Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$418.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$418.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$427.16 |
| Max. Negotiated Rate |
$1,770.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$711.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,597.72
|
| Rate for Payer: Heritage Provider Network Senior |
$1,597.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$590.00
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
IP
|
$1,204.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$217.92 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$711.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$815.11
|
| Rate for Payer: Heritage Provider Network Senior |
$815.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$301.00
|
| Rate for Payer: Multiplan Commercial |
$903.00
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
OP
|
$1,204.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$217.92 |
| Max. Negotiated Rate |
$1,024.00 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,024.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$827.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Blue Shield of California Commercial |
$290.30
|
| Rate for Payer: Blue Shield of California EPN |
$233.45
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: Cash Price |
$662.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$910.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Senior |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$453.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$573.00
|
| Rate for Payer: Heritage Provider Network Senior |
$521.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$353.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$574.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$521.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$301.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$571.75
|
| Rate for Payer: Multiplan Commercial |
$903.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$225.00
|
| Rate for Payer: TriValley Medical Group Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$418.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$418.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
OP
|
$2,442.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$74.13 |
| Max. Negotiated Rate |
$2,075.70 |
| Rate for Payer: Adventist Health Commercial |
$488.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,305.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,677.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,075.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,343.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,831.50
|
| Rate for Payer: Blue Shield of California Commercial |
$441.79
|
| Rate for Payer: Blue Shield of California EPN |
$355.27
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,075.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,075.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,075.70
|
| Rate for Payer: Dignity Health Senior |
$2,075.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,038.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$955.00
|
| Rate for Payer: Heritage Provider Network Senior |
$869.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$74.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,164.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,709.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,709.40
|
| Rate for Payer: Multiplan Commercial |
$1,831.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$325.00
|
| Rate for Payer: TriValley Medical Group Senior |
$325.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,221.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,221.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,075.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,075.70
|
| Rate for Payer: Vantage Medical Group Senior |
$2,075.70
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
IP
|
$2,442.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$1,831.50 |
| Rate for Payer: Adventist Health Commercial |
$488.40
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: Cash Price |
$1,343.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$929.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,653.23
|
| Rate for Payer: Heritage Provider Network Senior |
$1,653.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.50
|
| Rate for Payer: Multiplan Commercial |
$1,831.50
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$36.05 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Adventist Health Commercial |
$199.67
|
| Rate for Payer: Aetna of CA Gatekeeper |
$260.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$334.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.98
|
| Rate for Payer: Blue Shield of California Commercial |
$297.07
|
| Rate for Payer: Blue Shield of California EPN |
$237.66
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$316.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.98
|
| Rate for Payer: Dignity Health Senior |
$159.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$301.45
|
| Rate for Payer: Heritage Provider Network Senior |
$301.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$232.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$183.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.57
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$178.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.98
|
| Rate for Payer: Vantage Medical Group Senior |
$159.98
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
IP
|
$487.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$88.15 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Adventist Health Commercial |
$97.40
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$329.70
|
| Rate for Payer: Heritage Provider Network Senior |
$329.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
OP
|
$509.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$381.75 |
| Rate for Payer: Adventist Health Commercial |
$208.69
|
| Rate for Payer: Aetna of CA Gatekeeper |
$272.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$349.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.98
|
| Rate for Payer: Blue Shield of California Commercial |
$310.49
|
| Rate for Payer: Blue Shield of California EPN |
$248.39
|
| Rate for Payer: Cash Price |
$279.95
|
| Rate for Payer: Cash Price |
$279.95
|
| Rate for Payer: Cash Price |
$279.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$330.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.98
|
| Rate for Payer: Dignity Health Senior |
$159.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$315.07
|
| Rate for Payer: Heritage Provider Network Senior |
$315.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$242.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$183.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.57
|
| Rate for Payer: Multiplan Commercial |
$381.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$178.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.98
|
| Rate for Payer: Vantage Medical Group Senior |
$159.98
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
IP
|
$509.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$92.13 |
| Max. Negotiated Rate |
$381.75 |
| Rate for Payer: Adventist Health Commercial |
$101.80
|
| Rate for Payer: Cash Price |
$279.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$344.59
|
| Rate for Payer: Heritage Provider Network Senior |
$344.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.25
|
| Rate for Payer: Multiplan Commercial |
$381.75
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$3,214.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$581.73 |
| Max. Negotiated Rate |
$2,410.50 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| Rate for Payer: Cash Price |
$1,767.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,175.88
|
| Rate for Payer: Heritage Provider Network Senior |
$2,175.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$581.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.50
|
| Rate for Payer: Multiplan Commercial |
$2,410.50
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$3,214.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$85.05 |
| Max. Negotiated Rate |
$2,410.50 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,717.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,208.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Blue Shield of California Commercial |
$357.26
|
| Rate for Payer: Blue Shield of California EPN |
$287.30
|
| Rate for Payer: Cash Price |
$1,767.70
|
| Rate for Payer: Cash Price |
$1,767.70
|
| Rate for Payer: Cash Price |
$1,767.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,089.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Senior |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,089.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,989.47
|
| Rate for Payer: Heritage Provider Network Senior |
$1,989.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,533.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$581.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$498.53
|
| Rate for Payer: Multiplan Commercial |
$2,410.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$435.23
|
| Rate for Payer: TriValley Medical Group Senior |
$395.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$992.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$834.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Cash Price |
$121.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.62
|
| Rate for Payer: Heritage Provider Network Senior |
$149.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.25
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.45 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$118.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$151.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$131.84
|
| Rate for Payer: Blue Shield of California Commercial |
$147.97
|
| Rate for Payer: Blue Shield of California EPN |
$118.69
|
| Rate for Payer: Cash Price |
$121.55
|
| Rate for Payer: Cash Price |
$121.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$143.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Senior |
$25.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$143.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$136.80
|
| Rate for Payer: Heritage Provider Network Senior |
$136.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$105.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.07
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.45
|
| Rate for Payer: TriValley Medical Group Senior |
$25.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
OP
|
$2,131.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$327.13 |
| Max. Negotiated Rate |
$2,488.11 |
| Rate for Payer: Adventist Health Commercial |
$426.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,139.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,464.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Blue Shield of California Commercial |
$870.00
|
| Rate for Payer: Blue Shield of California EPN |
$699.62
|
| Rate for Payer: Cash Price |
$1,172.05
|
| Rate for Payer: Cash Price |
$1,172.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,385.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Senior |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,385.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,658.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,319.09
|
| Rate for Payer: Heritage Provider Network Senior |
$1,319.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$327.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,016.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,907.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$532.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,090.01
|
| Rate for Payer: Multiplan Commercial |
$1,598.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,824.61
|
| Rate for Payer: TriValley Medical Group Senior |
$1,658.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,065.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,065.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
IP
|
$2,131.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$385.71 |
| Max. Negotiated Rate |
$1,598.25 |
| Rate for Payer: Adventist Health Commercial |
$426.20
|
| Rate for Payer: Cash Price |
$1,172.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,442.69
|
| Rate for Payer: Heritage Provider Network Senior |
$1,442.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$532.75
|
| Rate for Payer: Multiplan Commercial |
$1,598.25
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
OP
|
$3,386.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$563.95 |
| Max. Negotiated Rate |
$2,539.50 |
| Rate for Payer: Adventist Health Commercial |
$677.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,809.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,326.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,682.02
|
| Rate for Payer: Blue Shield of California EPN |
$1,352.62
|
| Rate for Payer: Cash Price |
$1,862.30
|
| Rate for Payer: Cash Price |
$1,862.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,200.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Senior |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,200.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,658.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,095.93
|
| Rate for Payer: Heritage Provider Network Senior |
$2,095.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$563.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,615.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,907.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,090.01
|
| Rate for Payer: Multiplan Commercial |
$2,539.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,824.61
|
| Rate for Payer: TriValley Medical Group Senior |
$1,658.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,693.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,693.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
IP
|
$3,386.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$612.87 |
| Max. Negotiated Rate |
$2,539.50 |
| Rate for Payer: Adventist Health Commercial |
$677.20
|
| Rate for Payer: Cash Price |
$1,862.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,292.32
|
| Rate for Payer: Heritage Provider Network Senior |
$2,292.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.50
|
| Rate for Payer: Multiplan Commercial |
$2,539.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$2,835.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$513.13 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$567.00
|
| Rate for Payer: Cash Price |
$1,559.25
|
| Rate for Payer: Cash Price |
$1,559.25
|
| 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 |
$513.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$708.75
|
| Rate for Payer: Multiplan Commercial |
$2,126.25
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$2,547.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$461.01 |
| Max. Negotiated Rate |
$1,910.25 |
| Rate for Payer: Adventist Health Commercial |
$509.40
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,724.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,724.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.75
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$2,547.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$395.66 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$509.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,361.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,749.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,655.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Senior |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,655.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,724.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,724.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,214.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$498.53
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$916.41
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$843.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$2,547.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$461.01 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$509.40
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cash Price |
$1,400.85
|
| 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 |
$461.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.75
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$2,547.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$509.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,361.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,749.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| 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 |
$1,400.85
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cash Price |
$1,400.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Senior |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,655.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,576.59
|
| Rate for Payer: Heritage Provider Network Senior |
$486.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$186.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$751.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$498.53
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$435.23
|
| Rate for Payer: TriValley Medical Group Senior |
$395.66
|
| 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 |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
