|
HC BETA STREP RAPID TEST
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT 87430
|
| Hospital Charge Code |
900911635
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.98 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$88.87
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$93.43
|
| Rate for Payer: Heritage Provider Network Senior |
$93.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
|
|
HC BET V 2 (SILVER BIRCH), IGE
|
Facility
|
IP
|
$19.55
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$14.66 |
| Rate for Payer: Adventist Health Commercial |
$3.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.59
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.24
|
| Rate for Payer: Heritage Provider Network Senior |
$13.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.89
|
| Rate for Payer: Multiplan Commercial |
$14.66
|
|
|
HC BET V 2 (SILVER BIRCH), IGE
|
Facility
|
OP
|
$19.55
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.91
|
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.09
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.10
|
| Rate for Payer: Heritage Provider Network Senior |
$9.54
|
| Rate for Payer: Heritage Provider Network Senior |
$12.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Multiplan Commercial |
$14.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC BFLEX 2.8 BRONCHOSCOPE
|
Facility
|
IP
|
$808.00
|
|
| Hospital Charge Code |
900831711
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Adventist Health Commercial |
$161.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$520.35
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$547.02
|
| Rate for Payer: Heritage Provider Network Senior |
$547.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.00
|
| Rate for Payer: Multiplan Commercial |
$606.00
|
|
|
HC BFLEX 2.8 BRONCHOSCOPE
|
Facility
|
OP
|
$808.00
|
|
| Hospital Charge Code |
900831711
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$686.80 |
| Rate for Payer: Adventist Health Commercial |
$161.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$499.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$686.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$444.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$606.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$404.16
|
| Rate for Payer: Blue Shield of California Commercial |
$492.88
|
| Rate for Payer: Blue Shield of California EPN |
$394.30
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$525.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$686.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$686.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$686.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$476.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.15
|
| Rate for Payer: Heritage Provider Network Senior |
$500.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$385.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$565.60
|
| Rate for Payer: Multiplan Commercial |
$606.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$404.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$404.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$686.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$686.80
|
| Rate for Payer: Vantage Medical Group Senior |
$686.80
|
|
|
HC BFLEX 3.8 BRONCHOSCOPE
|
Facility
|
OP
|
$5,180.00
|
|
| Hospital Charge Code |
900831703
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$4,403.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,201.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,849.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,885.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,591.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3,159.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,527.84
|
| Rate for Payer: Cash Price |
$2,331.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,367.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,403.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,403.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,056.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,206.42
|
| Rate for Payer: Heritage Provider Network Senior |
$3,206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,470.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,626.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,590.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,590.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,403.00
|
|
|
HC BFLEX 3.8 BRONCHOSCOPE
|
Facility
|
IP
|
$5,180.00
|
|
| Hospital Charge Code |
900831703
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$3,885.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,335.92
|
| Rate for Payer: Cash Price |
$2,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,506.86
|
| Rate for Payer: Heritage Provider Network Senior |
$3,506.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
|
|
HC BFLEX 5.0 BRONCHOSCOPE
|
Facility
|
IP
|
$5,180.00
|
|
| Hospital Charge Code |
900831701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$3,885.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,335.92
|
| Rate for Payer: Cash Price |
$2,331.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,506.86
|
| Rate for Payer: Heritage Provider Network Senior |
$3,506.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
|
|
HC BFLEX 5.0 BRONCHOSCOPE
|
Facility
|
OP
|
$5,180.00
|
|
| Hospital Charge Code |
900831701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.58 |
| Max. Negotiated Rate |
$4,403.00 |
| Rate for Payer: Adventist Health Commercial |
$1,036.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,201.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,849.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,885.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,591.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3,159.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,527.84
|
| Rate for Payer: Cash Price |
$2,331.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,367.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,403.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,403.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,056.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,206.42
|
| Rate for Payer: Heritage Provider Network Senior |
$3,206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,470.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$937.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,626.00
|
| Rate for Payer: Multiplan Commercial |
$3,885.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,590.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,590.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,403.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,403.00
|
|
|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
OP
|
$1,195.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.29 |
| Max. Negotiated Rate |
$1,015.75 |
| Rate for Payer: Adventist Health Commercial |
$239.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$738.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$657.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$896.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$597.74
|
| Rate for Payer: Blue Shield of California Commercial |
$728.95
|
| Rate for Payer: Blue Shield of California EPN |
$583.16
|
| Rate for Payer: Cash Price |
$537.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$776.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,015.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,015.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$705.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$739.71
|
| Rate for Payer: Heritage Provider Network Senior |
$739.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$570.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$216.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$836.50
|
| Rate for Payer: Multiplan Commercial |
$896.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$597.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$597.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,015.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,015.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,015.75
|
|
|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
IP
|
$1,195.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.29 |
| Max. Negotiated Rate |
$896.25 |
| Rate for Payer: Adventist Health Commercial |
$239.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$769.58
|
| Rate for Payer: Cash Price |
$537.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$809.01
|
| Rate for Payer: Heritage Provider Network Senior |
$809.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$216.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.75
|
| Rate for Payer: Multiplan Commercial |
$896.25
|
|
|
HC BG ARTERIAL PUNCTURE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$39.04
|
| Rate for Payer: Blue Shield of California EPN |
$31.23
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$171.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.62
|
| Rate for Payer: Heritage Provider Network Senior |
$39.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$30.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$196.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$188.23
|
| Rate for Payer: TriValley Medical Group Senior |
$171.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$32.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$32.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC BG ARTERIAL PUNCTURE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.33
|
| Rate for Payer: Heritage Provider Network Senior |
$43.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
|
|
HC BG IONIZED CALCIUM
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$82.36 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$293.02
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$308.04
|
| Rate for Payer: Heritage Provider Network Senior |
$308.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
|
|
HC BG IONIZED CALCIUM
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$281.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.76
|
| Rate for Payer: Blue Shield of California Commercial |
$109.96
|
| Rate for Payer: Blue Shield of California EPN |
$88.20
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$295.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$281.64
|
| Rate for Payer: Heritage Provider Network Senior |
$281.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$217.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.33
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.68
|
| Rate for Payer: TriValley Medical Group Senior |
$13.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
IP
|
$14,725.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,665.22 |
| Max. Negotiated Rate |
$11,043.75 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,482.90
|
| Rate for Payer: Cash Price |
$6,626.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,968.83
|
| Rate for Payer: Heritage Provider Network Senior |
$9,968.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,665.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,681.25
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
OP
|
$14,725.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,665.22 |
| Max. Negotiated Rate |
$11,043.75 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,100.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 |
$6,626.25
|
| Rate for Payer: Cash Price |
$6,626.25
|
| Rate for Payer: Cash Price |
$6,626.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,571.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,604.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,114.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5,664.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8,749.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,665.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,295.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,681.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,065.49
|
| Rate for Payer: TriValley Medical Group Senior |
$5,065.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
IP
|
$11,361.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,056.34 |
| Max. Negotiated Rate |
$8,520.75 |
| Rate for Payer: Adventist Health Commercial |
$2,272.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,316.48
|
| Rate for Payer: Cash Price |
$5,112.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,691.40
|
| Rate for Payer: Heritage Provider Network Senior |
$7,691.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,056.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,840.25
|
| Rate for Payer: Multiplan Commercial |
$8,520.75
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
OP
|
$11,361.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,056.34 |
| Max. Negotiated Rate |
$15,820.18 |
| Rate for Payer: Adventist Health Commercial |
$2,272.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,021.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,326.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| 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 |
$5,112.45
|
| Rate for Payer: Cash Price |
$5,112.45
|
| Rate for Payer: Cash Price |
$5,112.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,384.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,159.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,326.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,326.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,032.46
|
| Rate for Payer: Heritage Provider Network Senior |
$10,241.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,326.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$15,820.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,056.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,575.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,840.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,157.39
|
| Rate for Payer: Multiplan Commercial |
$8,520.75
|
| Rate for Payer: Multiplan WC |
$12,632.22
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,159.05
|
| Rate for Payer: TriValley Medical Group Senior |
$9,159.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Vantage Medical Group Senior |
$8,326.41
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
IP
|
$3,265.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.97 |
| Max. Negotiated Rate |
$2,448.75 |
| Rate for Payer: Adventist Health Commercial |
$653.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,102.66
|
| Rate for Payer: Cash Price |
$1,469.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,210.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,210.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$590.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$816.25
|
| Rate for Payer: Multiplan Commercial |
$2,448.75
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
OP
|
$3,265.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$653.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,017.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 |
$1,469.25
|
| Rate for Payer: Cash Price |
$1,469.25
|
| Rate for Payer: Cash Price |
$1,469.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,122.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,021.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,216.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$590.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$816.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,448.75
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,283.18
|
| Rate for Payer: TriValley Medical Group Senior |
$1,283.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
OP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$258.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.04
|
| Rate for Payer: Blue Shield of California EPN |
$168.04
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$192.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$355.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$355.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$193.53
|
| Rate for Payer: Heritage Provider Network Senior |
$193.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$209.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$292.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$355.30
|
| Rate for Payer: Vantage Medical Group Senior |
$355.30
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
IP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$269.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.04
|
| Rate for Payer: Blue Shield of California EPN |
$168.04
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$192.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$193.53
|
| Rate for Payer: Heritage Provider Network Senior |
$193.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$209.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.50
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.40
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
IP
|
$21,927.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,968.79 |
| Max. Negotiated Rate |
$16,445.25 |
| Rate for Payer: Adventist Health Commercial |
$4,385.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,120.99
|
| Rate for Payer: Cash Price |
$9,867.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,844.58
|
| Rate for Payer: Heritage Provider Network Senior |
$14,844.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,968.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,481.75
|
| Rate for Payer: Multiplan Commercial |
$16,445.25
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
OP
|
$21,927.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,968.79 |
| Max. Negotiated Rate |
$25,976.31 |
| Rate for Payer: Adventist Health Commercial |
$4,385.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,550.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$9,867.15
|
| Rate for Payer: Cash Price |
$9,867.15
|
| Rate for Payer: Cash Price |
$9,867.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,252.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,671.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,572.81
|
| Rate for Payer: Heritage Provider Network Senior |
$16,816.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25,976.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,968.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,722.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,481.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$16,445.25
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,038.91
|
| Rate for Payer: TriValley Medical Group Senior |
$15,038.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
