|
HC EGD W/REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$4,013.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
906743247
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$726.35 |
| Max. Negotiated Rate |
$3,009.75 |
| Rate for Payer: Adventist Health Commercial |
$802.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,756.93
|
| Rate for Payer: Cash Price |
$1,805.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,716.80
|
| Rate for Payer: Heritage Provider Network Senior |
$2,716.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$726.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,003.25
|
| Rate for Payer: Multiplan Commercial |
$3,009.75
|
|
|
HC EGD W/REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$3,658.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
906743247
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$398.42 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$731.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,513.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,377.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: Dignity Health Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,132.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,264.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,393.09
|
| Rate for Payer: Humana Medicare |
$1,132.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$398.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,151.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,336.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,427.06
|
| Rate for Payer: Multiplan Commercial |
$2,743.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC EGD W/REMOV TUMOR/POLYP/LESION
|
Facility
|
IP
|
$2,439.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
906743251
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$441.46 |
| Max. Negotiated Rate |
$1,829.25 |
| Rate for Payer: Adventist Health Commercial |
$487.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,675.59
|
| Rate for Payer: Cash Price |
$1,097.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,651.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,651.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$441.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.75
|
| Rate for Payer: Multiplan Commercial |
$1,829.25
|
|
|
HC EGD W/REMOV TUMOR/POLYP/LESION
|
Facility
|
OP
|
$2,351.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
906743251
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$470.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,615.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,057.95
|
| Rate for Payer: Cash Price |
$1,057.95
|
| Rate for Payer: Cash Price |
$1,057.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,528.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: Dignity Health Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,377.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,455.27
|
| Rate for Payer: Heritage Provider Network Senior |
$2,924.26
|
| Rate for Payer: Humana Medicare |
$2,377.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,517.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$425.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,805.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$587.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,995.59
|
| Rate for Payer: Multiplan Commercial |
$1,763.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC EGD W/TRANSENDO TUBE/CATH PLAC
|
Facility
|
OP
|
$3,553.00
|
|
|
Service Code
|
CPT 43241
|
| Hospital Charge Code |
906743241
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$710.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,440.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,598.85
|
| Rate for Payer: Cash Price |
$1,598.85
|
| Rate for Payer: Cash Price |
$1,598.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,309.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: Dignity Health Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,377.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,199.31
|
| Rate for Payer: Heritage Provider Network Senior |
$2,924.26
|
| Rate for Payer: Humana Medicare |
$2,377.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,517.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,805.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$888.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,995.59
|
| Rate for Payer: Multiplan Commercial |
$2,664.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC EGD W/TRANSENDO TUBE/CATH PLAC
|
Facility
|
IP
|
$3,898.00
|
|
|
Service Code
|
CPT 43241
|
| Hospital Charge Code |
906743241
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$705.54 |
| Max. Negotiated Rate |
$2,923.50 |
| Rate for Payer: Adventist Health Commercial |
$779.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,677.93
|
| Rate for Payer: Cash Price |
$1,754.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,638.95
|
| Rate for Payer: Heritage Provider Network Senior |
$2,638.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$705.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$974.50
|
| Rate for Payer: Multiplan Commercial |
$2,923.50
|
|
|
HC EGD W/TRNSMRL DRNG/ PSEUDOCYST
|
Facility
|
IP
|
$2,449.00
|
|
|
Service Code
|
CPT 43240
|
| Hospital Charge Code |
906743240
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$443.27 |
| Max. Negotiated Rate |
$1,836.75 |
| Rate for Payer: Adventist Health Commercial |
$489.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,682.46
|
| Rate for Payer: Cash Price |
$1,102.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,657.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,657.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$612.25
|
| Rate for Payer: Multiplan Commercial |
$1,836.75
|
|
|
HC EGD W/TRNSMRL DRNG/ PSEUDOCYST
|
Facility
|
OP
|
$3,834.00
|
|
|
Service Code
|
CPT 43240
|
| Hospital Charge Code |
906743240
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$13,529.58 |
| Rate for Payer: Adventist Health Commercial |
$766.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,633.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,725.30
|
| Rate for Payer: Cash Price |
$1,725.30
|
| Rate for Payer: Cash Price |
$1,725.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,492.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: Dignity Health Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,120.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,373.25
|
| Rate for Payer: Heritage Provider Network Senior |
$8,758.62
|
| Rate for Payer: Humana Medicare |
$7,120.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$545.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,120.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,529.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$693.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,402.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$958.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,972.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,972.25
|
| Rate for Payer: Multiplan Commercial |
$2,875.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,096.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5,971.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC EGD W/US GUID INTRMRL
|
Facility
|
OP
|
$4,416.00
|
|
|
Service Code
|
CPT 43242
|
| Hospital Charge Code |
906743242
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$391.45 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$883.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,033.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,987.20
|
| Rate for Payer: Cash Price |
$1,987.20
|
| Rate for Payer: Cash Price |
$1,987.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,870.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: Dignity Health Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,377.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,733.50
|
| Rate for Payer: Heritage Provider Network Senior |
$2,924.26
|
| Rate for Payer: Humana Medicare |
$2,377.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$391.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,517.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$799.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,805.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,104.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,995.59
|
| Rate for Payer: Multiplan Commercial |
$3,312.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC EGD W/US GUID INTRMRL
|
Facility
|
IP
|
$4,844.00
|
|
|
Service Code
|
CPT 43242
|
| Hospital Charge Code |
906743242
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$876.76 |
| Max. Negotiated Rate |
$3,633.00 |
| Rate for Payer: Adventist Health Commercial |
$968.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,327.83
|
| Rate for Payer: Cash Price |
$2,179.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,279.39
|
| Rate for Payer: Heritage Provider Network Senior |
$3,279.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,211.00
|
| Rate for Payer: Multiplan Commercial |
$3,633.00
|
|
|
HC EGFR
|
Facility
|
OP
|
$364.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
903800314
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.88 |
| Max. Negotiated Rate |
$616.70 |
| Rate for Payer: Adventist Health Commercial |
$72.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$432.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$250.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$486.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$357.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.64
|
| Rate for Payer: Cash Price |
$163.80
|
| Rate for Payer: Cash Price |
$163.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$236.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$486.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$357.04
|
| Rate for Payer: Dignity Health Senior |
$324.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$324.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.32
|
| Rate for Payer: Heritage Provider Network Senior |
$225.32
|
| Rate for Payer: Humana Medicare |
$324.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$280.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$324.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$616.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$383.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.97
|
| Rate for Payer: Multiplan Commercial |
$273.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$324.58
|
| Rate for Payer: TriValley Medical Group Senior |
$324.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$350.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$350.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$486.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$357.04
|
| Rate for Payer: Vantage Medical Group Senior |
$324.58
|
|
|
HC EGFR
|
Facility
|
IP
|
$503.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
903800314
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.04 |
| Max. Negotiated Rate |
$377.25 |
| Rate for Payer: Adventist Health Commercial |
$100.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$345.56
|
| Rate for Payer: Cash Price |
$226.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$340.53
|
| Rate for Payer: Heritage Provider Network Senior |
$340.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.75
|
| Rate for Payer: Multiplan Commercial |
$377.25
|
|
|
HC EKOS THROMLYSIS CATH
|
Facility
|
OP
|
$6,704.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.80 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$1,340.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,217.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,605.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,698.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,687.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,028.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,163.18
|
| Rate for Payer: Blue Shield of California EPN |
$3,935.25
|
| Rate for Payer: Cash Price |
$3,016.80
|
| Rate for Payer: Cash Price |
$3,016.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,083.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,698.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,698.40
|
| Rate for Payer: Dignity Health Senior |
$5,698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,290.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,103.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3,103.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,352.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,676.00
|
| Rate for Payer: Multiplan Commercial |
$5,028.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,444.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,239.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,698.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5,698.40
|
|
|
HC EKOS THROMLYSIS CATH
|
Facility
|
IP
|
$6,704.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.80 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$1,340.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,217.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,605.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$3,016.80
|
| Rate for Payer: Cash Price |
$3,016.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,083.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,620.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,538.61
|
| Rate for Payer: Heritage Provider Network Senior |
$4,538.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,352.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,676.00
|
| Rate for Payer: Multiplan Commercial |
$5,028.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,444.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,239.81
|
|
|
HC ELASTOPLAST
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.24
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.12
|
| Rate for Payer: Heritage Provider Network Senior |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
|
|
HC ELASTOPLAST
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7.45
|
| Rate for Payer: Blue Shield of California EPN |
$7.04
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Senior |
$10.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.43
|
| Rate for Payer: Heritage Provider Network Senior |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$474.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$85.79 |
| Max. Negotiated Rate |
$355.50 |
| Rate for Payer: Adventist Health Commercial |
$94.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$325.64
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.90
|
| Rate for Payer: Heritage Provider Network Senior |
$320.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.50
|
| Rate for Payer: Multiplan Commercial |
$355.50
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$474.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$85.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$94.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$325.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$355.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$308.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.90
|
| Rate for Payer: Dignity Health Senior |
$402.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.90
|
| Rate for Payer: Heritage Provider Network Senior |
$320.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$228.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.50
|
| Rate for Payer: Multiplan Commercial |
$355.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$172.11
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$158.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.90
|
| Rate for Payer: Vantage Medical Group Senior |
$402.90
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$474.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$94.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$325.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$355.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$308.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.90
|
| Rate for Payer: Dignity Health Senior |
$402.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$293.41
|
| Rate for Payer: Heritage Provider Network Senior |
$293.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$318.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$228.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.50
|
| Rate for Payer: Multiplan Commercial |
$355.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.90
|
| Rate for Payer: Vantage Medical Group Senior |
$402.90
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$474.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.79 |
| Max. Negotiated Rate |
$355.50 |
| Rate for Payer: Adventist Health Commercial |
$94.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$325.64
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.90
|
| Rate for Payer: Heritage Provider Network Senior |
$320.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.50
|
| Rate for Payer: Multiplan Commercial |
$355.50
|
|
|
HC ELBOW COMPLETE
|
Facility
|
OP
|
$646.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.53 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Adventist Health Commercial |
$129.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.18
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.59
|
| Rate for Payer: Blue Shield of California Commercial |
$117.39
|
| Rate for Payer: Blue Shield of California EPN |
$66.75
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$419.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: Dignity Health Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$399.87
|
| Rate for Payer: Heritage Provider Network Senior |
$399.87
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143.06
|
| Rate for Payer: Multiplan Commercial |
$484.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$113.54
|
| Rate for Payer: TriValley Medical Group Senior |
$113.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ELBOW COMPLETE
|
Facility
|
IP
|
$646.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.93 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Adventist Health Commercial |
$129.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.80
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$437.34
|
| Rate for Payer: Heritage Provider Network Senior |
$437.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.50
|
| Rate for Payer: Multiplan Commercial |
$484.50
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
OP
|
$505.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Adventist Health Commercial |
$101.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$45.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$346.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.99
|
| Rate for Payer: Blue Shield of California Commercial |
$104.76
|
| Rate for Payer: Blue Shield of California EPN |
$59.57
|
| Rate for Payer: Cash Price |
$227.25
|
| Rate for Payer: Cash Price |
$227.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$328.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: Dignity Health Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$312.60
|
| Rate for Payer: Heritage Provider Network Senior |
$312.60
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143.06
|
| Rate for Payer: Multiplan Commercial |
$378.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$113.54
|
| Rate for Payer: TriValley Medical Group Senior |
$113.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
IP
|
$505.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Adventist Health Commercial |
$101.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$346.94
|
| Rate for Payer: Cash Price |
$227.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$341.88
|
| Rate for Payer: Heritage Provider Network Senior |
$341.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.25
|
| Rate for Payer: Multiplan Commercial |
$378.75
|
|
|
HC ELECTROGSTROGRPHY DIAG TRANSCU
|
Facility
|
OP
|
$1,567.00
|
|
|
Service Code
|
CPT 91132
|
| Hospital Charge Code |
906791132
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$146.70 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$313.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$272.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,076.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$705.15
|
| Rate for Payer: Cash Price |
$705.15
|
| Rate for Payer: Cash Price |
$705.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,018.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: Dignity Health Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$392.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$969.97
|
| Rate for Payer: Heritage Provider Network Senior |
$482.37
|
| Rate for Payer: Humana Medicare |
$392.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$146.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$745.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$462.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$494.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$494.13
|
| Rate for Payer: Multiplan Commercial |
$1,175.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
