|
HC APPLICATION OF HAND/WRIST CAST MCAL
|
Facility
OP
|
$995.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
901300001
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$199.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$136.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$683.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$646.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$216.56
|
| Rate for Payer: Dignity Health Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$196.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$615.90
|
| Rate for Payer: Heritage Provider Network Senior |
$615.90
|
| Rate for Payer: Humana Medicare |
$196.87
|
| Rate for Payer: IEHP Medi-Cal |
$130.10
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$374.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$232.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$248.06
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC APPLICATION OF HAND/WRIST CAST MCAL
|
Facility
IP
|
$995.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
901300001
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$180.10 |
| Max. Negotiated Rate |
$746.25 |
| Rate for Payer: Adventist Health Commercial |
$199.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$683.56
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$673.62
|
| Rate for Payer: Heritage Provider Network Senior |
$673.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.75
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
|
|
HC APPLICATION OF LONG ARM CAST
|
Facility
OP
|
$627.00
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
900501251
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.49 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$139.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$430.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$407.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: Dignity Health Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$424.48
|
| Rate for Payer: Heritage Provider Network Senior |
$424.48
|
| Rate for Payer: Humana Medicare |
$335.55
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$302.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.79
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$227.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC APPLICATION OF LONG ARM CAST
|
Facility
IP
|
$627.00
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
900501251
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.49 |
| Max. Negotiated Rate |
$470.25 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$430.75
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$424.48
|
| Rate for Payer: Heritage Provider Network Senior |
$424.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.75
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
|
|
HC APP LONG LEG CAST
|
Facility
OP
|
$553.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
900501281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$110.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$379.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$359.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: Dignity Health Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$374.38
|
| Rate for Payer: Heritage Provider Network Senior |
$374.38
|
| Rate for Payer: Humana Medicare |
$335.55
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$266.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.79
|
| Rate for Payer: Multiplan Commercial |
$414.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$200.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$184.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC APP LONG LEG CAST
|
Facility
IP
|
$553.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
900501281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Adventist Health Commercial |
$110.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$379.91
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$374.38
|
| Rate for Payer: Heritage Provider Network Senior |
$374.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.25
|
| Rate for Payer: Multiplan Commercial |
$414.75
|
|
|
HC APPL TISS GLUE REPAIR EYE WND
|
Facility
IP
|
$2,640.00
|
|
|
Service Code
|
CPT 65286
|
| Hospital Charge Code |
900501481
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$477.84 |
| Max. Negotiated Rate |
$1,980.00 |
| Rate for Payer: Adventist Health Commercial |
$528.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,813.68
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,787.28
|
| Rate for Payer: Heritage Provider Network Senior |
$1,787.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$477.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Multiplan Commercial |
$1,980.00
|
|
|
HC APPL TISS GLUE REPAIR EYE WND
|
Facility
OP
|
$2,640.00
|
|
|
Service Code
|
CPT 65286
|
| Hospital Charge Code |
900501481
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$477.84 |
| Max. Negotiated Rate |
$4,367.44 |
| Rate for Payer: Adventist Health Commercial |
$528.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,813.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,716.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: Dignity Health Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,716.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,911.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,787.28
|
| Rate for Payer: Heritage Provider Network Senior |
$1,787.28
|
| Rate for Payer: Humana Medicare |
$2,911.63
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,911.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,272.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$477.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,435.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,668.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,668.65
|
| Rate for Payer: Multiplan Commercial |
$1,980.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$958.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$882.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
OP
|
$888.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.80 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$134.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$610.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$577.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: Dignity Health Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$601.18
|
| Rate for Payer: Heritage Provider Network Senior |
$601.18
|
| Rate for Payer: Humana Medicare |
$335.55
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$428.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$222.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.79
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$322.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$296.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
IP
|
$888.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.73 |
| Max. Negotiated Rate |
$666.00 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$610.06
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$601.18
|
| Rate for Payer: Heritage Provider Network Senior |
$601.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$222.00
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
OP
|
$748.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903208876
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.28 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$149.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$68.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$513.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$486.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: Dignity Health Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$76.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$463.01
|
| Rate for Payer: Heritage Provider Network Senior |
$463.01
|
| Rate for Payer: Humana Medicare |
$76.42
|
| Rate for Payer: IEHP Medi-Cal |
$52.28
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$145.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$135.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.29
|
| Rate for Payer: Multiplan Commercial |
$561.00
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
IP
|
$748.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903208876
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$135.39 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$149.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$513.88
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$506.40
|
| Rate for Payer: Heritage Provider Network Senior |
$506.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$135.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.00
|
| Rate for Payer: Multiplan Commercial |
$561.00
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC MCAL
|
Facility
OP
|
$748.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
901300011
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.28 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$149.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$68.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$513.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$486.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: Dignity Health Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$76.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$463.01
|
| Rate for Payer: Heritage Provider Network Senior |
$463.01
|
| Rate for Payer: Humana Medicare |
$76.42
|
| Rate for Payer: IEHP Medi-Cal |
$52.28
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$145.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$135.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.29
|
| Rate for Payer: Multiplan Commercial |
$561.00
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC MCAL
|
Facility
IP
|
$748.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
901300011
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$135.39 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$149.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$513.88
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$506.40
|
| Rate for Payer: Heritage Provider Network Senior |
$506.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$135.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.00
|
| Rate for Payer: Multiplan Commercial |
$561.00
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
OP
|
$264.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$181.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$171.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.73
|
| Rate for Payer: Heritage Provider Network Senior |
$178.73
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$127.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$95.86
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$88.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
IP
|
$264.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$181.37
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.73
|
| Rate for Payer: Heritage Provider Network Senior |
$178.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
OP
|
$264.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$181.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$171.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.42
|
| Rate for Payer: Heritage Provider Network Senior |
$163.42
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: IEHP Medi-Cal |
$59.23
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$303.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
IP
|
$264.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$181.37
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.73
|
| Rate for Payer: Heritage Provider Network Senior |
$178.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
|
|
HC APP OF FINGER SPLINT-STATIC MCAL
|
Facility
OP
|
$1,184.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
901300009
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.06 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$236.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$813.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$769.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$732.90
|
| Rate for Payer: Heritage Provider Network Senior |
$732.90
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: IEHP Medi-Cal |
$59.23
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$303.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$888.00
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC APP OF FINGER SPLINT-STATIC MCAL
|
Facility
IP
|
$1,184.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
901300009
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$214.30 |
| Max. Negotiated Rate |
$888.00 |
| Rate for Payer: Adventist Health Commercial |
$236.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$813.41
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$801.57
|
| Rate for Payer: Heritage Provider Network Senior |
$801.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.00
|
| Rate for Payer: Multiplan Commercial |
$888.00
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
OP
|
$627.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.49 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$430.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$407.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: Dignity Health Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$424.48
|
| Rate for Payer: Heritage Provider Network Senior |
$424.48
|
| Rate for Payer: Humana Medicare |
$335.55
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$302.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.79
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$227.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
IP
|
$627.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.49 |
| Max. Negotiated Rate |
$470.25 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$430.75
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$424.48
|
| Rate for Payer: Heritage Provider Network Senior |
$424.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.75
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
|
|
HC APP OF INTERDENTAL FIXATION
|
Facility
OP
|
$1,592.00
|
|
|
Service Code
|
CPT 21110
|
| Hospital Charge Code |
900501575
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.15 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$318.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,093.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$716.40
|
| Rate for Payer: Cash Price |
$716.40
|
| Rate for Payer: Cash Price |
$716.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,034.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: Dignity Health Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,905.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,077.78
|
| Rate for Payer: Heritage Provider Network Senior |
$1,077.78
|
| Rate for Payer: Humana Medicare |
$1,905.44
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,905.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$767.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$398.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,400.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,400.85
|
| Rate for Payer: Multiplan Commercial |
$1,194.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$578.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$531.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC APP OF INTERDENTAL FIXATION
|
Facility
IP
|
$1,592.00
|
|
|
Service Code
|
CPT 21110
|
| Hospital Charge Code |
900501575
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.15 |
| Max. Negotiated Rate |
$1,194.00 |
| Rate for Payer: Adventist Health Commercial |
$318.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,093.70
|
| Rate for Payer: Cash Price |
$716.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,077.78
|
| Rate for Payer: Heritage Provider Network Senior |
$1,077.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$398.00
|
| Rate for Payer: Multiplan Commercial |
$1,194.00
|
|
|
HC APP OF LONG ARM SPLINT
|
Facility
OP
|
$580.00
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
900501100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$120.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$398.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$377.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$216.56
|
| Rate for Payer: Dignity Health Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$196.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.66
|
| Rate for Payer: Heritage Provider Network Senior |
$392.66
|
| Rate for Payer: Humana Medicare |
$196.87
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$279.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$232.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$248.06
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$210.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$193.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
