|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
OP
|
$1,906.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.99 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$381.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,309.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,620.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,048.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,429.50
|
| 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 |
$857.70
|
| Rate for Payer: Cash Price |
$857.70
|
| Rate for Payer: Cash Price |
$857.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,238.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,620.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,620.10
|
| Rate for Payer: Dignity Health Senior |
$1,620.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,179.81
|
| Rate for Payer: Heritage Provider Network Senior |
$1,179.81
|
| Rate for Payer: IEHP Medi-Cal |
$1,686.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$918.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.50
|
| Rate for Payer: Multiplan Commercial |
$1,429.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,620.10
|
| Rate for Payer: Vantage Medical Group Senior |
$1,620.10
|
|
|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
IP
|
$1,906.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.99 |
| Max. Negotiated Rate |
$1,429.50 |
| Rate for Payer: Adventist Health Commercial |
$381.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,309.42
|
| Rate for Payer: Cash Price |
$857.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,290.36
|
| Rate for Payer: Heritage Provider Network Senior |
$1,290.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.50
|
| Rate for Payer: Multiplan Commercial |
$1,429.50
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
IP
|
$7,580.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,371.98 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Adventist Health Commercial |
$1,516.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,207.46
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,131.66
|
| Rate for Payer: Heritage Provider Network Senior |
$5,131.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,371.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Multiplan Commercial |
$5,685.00
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
OP
|
$7,580.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.96 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,516.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,207.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,443.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,169.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,685.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,927.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,443.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,443.00
|
| Rate for Payer: Dignity Health Senior |
$6,443.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,692.02
|
| Rate for Payer: Heritage Provider Network Senior |
$4,692.02
|
| Rate for Payer: IEHP Medi-Cal |
$200.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,653.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,371.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Multiplan Commercial |
$5,685.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,443.00
|
| Rate for Payer: Vantage Medical Group Senior |
$6,443.00
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
IP
|
$6,591.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,192.97 |
| Max. Negotiated Rate |
$4,943.25 |
| Rate for Payer: Adventist Health Commercial |
$1,318.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,528.02
|
| Rate for Payer: Cash Price |
$2,965.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,462.11
|
| Rate for Payer: Heritage Provider Network Senior |
$4,462.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,647.75
|
| Rate for Payer: Multiplan Commercial |
$4,943.25
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
OP
|
$6,591.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,192.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,318.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,528.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| 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 |
$2,965.95
|
| Rate for Payer: Cash Price |
$2,965.95
|
| Rate for Payer: Cash Price |
$2,965.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,284.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: Dignity Health Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,079.83
|
| Rate for Payer: Heritage Provider Network Senior |
$5,755.08
|
| Rate for Payer: Humana Medicare |
$4,678.93
|
| Rate for Payer: IEHP Medi-Cal |
$1,289.93
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,889.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,521.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,647.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,895.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,895.45
|
| Rate for Payer: Multiplan Commercial |
$4,943.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,146.82
|
| Rate for Payer: TriValley Medical Group Senior |
$5,146.82
|
| 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 |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
IP
|
$7,580.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,371.98 |
| Max. Negotiated Rate |
$5,685.00 |
| Rate for Payer: Adventist Health Commercial |
$1,516.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,207.46
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,131.66
|
| Rate for Payer: Heritage Provider Network Senior |
$5,131.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,371.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Multiplan Commercial |
$5,685.00
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
OP
|
$7,580.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,370.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,516.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,207.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| 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 |
$3,411.00
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Cash Price |
$3,411.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,927.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: Dignity Health Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,678.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,692.02
|
| Rate for Payer: Heritage Provider Network Senior |
$5,755.08
|
| Rate for Payer: Humana Medicare |
$4,678.93
|
| Rate for Payer: IEHP Medi-Cal |
$1,370.09
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,889.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,371.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,521.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,895.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,895.45
|
| Rate for Payer: Multiplan Commercial |
$5,685.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,146.82
|
| Rate for Payer: TriValley Medical Group Senior |
$5,146.82
|
| 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 |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
IP
|
$3,727.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$674.59 |
| Max. Negotiated Rate |
$2,795.25 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,523.18
|
| Rate for Payer: Heritage Provider Network Senior |
$2,523.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
OP
|
$3,727.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.24 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,314.47
|
| Rate for Payer: Blue Shield of California EPN |
$2,187.75
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,422.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: Dignity Health Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,307.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,307.01
|
| Rate for Payer: Humana Medicare |
$2,120.62
|
| Rate for Payer: IEHP Medi-Cal |
$325.24
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,502.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,671.98
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,332.68
|
| Rate for Payer: TriValley Medical Group Senior |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
OP
|
$11,669.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.97 |
| Max. Negotiated Rate |
$16,247.85 |
| Rate for Payer: Adventist Health Commercial |
$2,333.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,016.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| 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 |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,584.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: Dignity Health Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,551.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,223.11
|
| Rate for Payer: Heritage Provider Network Senior |
$10,518.34
|
| Rate for Payer: Humana Medicare |
$8,551.50
|
| Rate for Payer: IEHP Medi-Cal |
$290.97
|
| Rate for Payer: IEHP Medicare Advantage |
$8,551.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,247.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,090.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,774.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,774.89
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,406.65
|
| Rate for Payer: TriValley Medical Group Senior |
$9,406.65
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
IP
|
$11,669.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,112.09 |
| Max. Negotiated Rate |
$8,751.75 |
| Rate for Payer: Adventist Health Commercial |
$2,333.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,016.60
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,899.91
|
| Rate for Payer: Heritage Provider Network Senior |
$7,899.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.25
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
OP
|
$11,669.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$306.65 |
| Max. Negotiated Rate |
$16,247.85 |
| Rate for Payer: Adventist Health Commercial |
$2,333.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,016.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,584.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: Dignity Health Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,551.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,223.11
|
| Rate for Payer: Heritage Provider Network Senior |
$10,518.34
|
| Rate for Payer: Humana Medicare |
$8,551.50
|
| Rate for Payer: IEHP Medi-Cal |
$306.65
|
| Rate for Payer: IEHP Medicare Advantage |
$8,551.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,247.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,090.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,774.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,774.89
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,406.65
|
| Rate for Payer: TriValley Medical Group Senior |
$9,406.65
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
IP
|
$11,669.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,112.09 |
| Max. Negotiated Rate |
$8,751.75 |
| Rate for Payer: Adventist Health Commercial |
$2,333.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,016.60
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,899.91
|
| Rate for Payer: Heritage Provider Network Senior |
$7,899.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.25
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
IP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Adventist Health Commercial |
$160.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$549.60
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$541.60
|
| Rate for Payer: Heritage Provider Network Senior |
$541.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
OP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Adventist Health Commercial |
$160.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$427.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$549.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$600.00
|
| Rate for Payer: Blue Shield of California Commercial |
$496.80
|
| Rate for Payer: Blue Shield of California EPN |
$469.60
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$520.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: Dignity Health Senior |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$520.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$495.20
|
| Rate for Payer: Heritage Provider Network Senior |
$495.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$385.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
OP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Adventist Health Commercial |
$160.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$427.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$549.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$600.00
|
| Rate for Payer: Blue Shield of California Commercial |
$496.80
|
| Rate for Payer: Blue Shield of California EPN |
$469.60
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$520.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: Dignity Health Senior |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$520.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$495.20
|
| Rate for Payer: Heritage Provider Network Senior |
$495.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$385.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
IP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Adventist Health Commercial |
$160.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$549.60
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$541.60
|
| Rate for Payer: Heritage Provider Network Senior |
$541.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
OP
|
$3,727.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,422.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: Dignity Health Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,307.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,608.36
|
| Rate for Payer: Humana Medicare |
$2,120.62
|
| Rate for Payer: IEHP Medi-Cal |
$332.79
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,502.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,671.98
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,332.68
|
| Rate for Payer: TriValley Medical Group Senior |
$2,332.68
|
| 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 |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
IP
|
$3,727.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$674.59 |
| Max. Negotiated Rate |
$2,795.25 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,523.18
|
| Rate for Payer: Heritage Provider Network Senior |
$2,523.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
IP
|
$3,727.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$674.59 |
| Max. Negotiated Rate |
$2,795.25 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,523.18
|
| Rate for Payer: Heritage Provider Network Senior |
$2,523.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
OP
|
$3,727.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$674.59 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$745.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,560.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cash Price |
$1,677.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,422.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: Dignity Health Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,523.18
|
| Rate for Payer: Heritage Provider Network Senior |
$2,523.18
|
| Rate for Payer: Humana Medicare |
$2,120.62
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,796.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,502.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,671.98
|
| Rate for Payer: Multiplan Commercial |
$2,795.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,353.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,245.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
OP
|
$4,772.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.52 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$954.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,278.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,963.41
|
| Rate for Payer: Blue Shield of California EPN |
$2,801.16
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,101.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: Dignity Health Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,953.87
|
| Rate for Payer: Heritage Provider Network Senior |
$2,953.87
|
| Rate for Payer: Humana Medicare |
$2,120.62
|
| Rate for Payer: IEHP Medi-Cal |
$280.52
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$863.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,502.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,671.98
|
| Rate for Payer: Multiplan Commercial |
$3,579.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,332.68
|
| Rate for Payer: TriValley Medical Group Senior |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
IP
|
$4,772.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$863.73 |
| Max. Negotiated Rate |
$3,579.00 |
| Rate for Payer: Adventist Health Commercial |
$954.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,278.36
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,230.64
|
| Rate for Payer: Heritage Provider Network Senior |
$3,230.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$863.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.00
|
| Rate for Payer: Multiplan Commercial |
$3,579.00
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
OP
|
$5,205.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$102.21 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,041.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,575.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,424.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,862.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,903.75
|
| 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 |
$2,342.25
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,383.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,424.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.25
|
| Rate for Payer: Dignity Health Senior |
$4,424.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,221.90
|
| Rate for Payer: Heritage Provider Network Senior |
$3,221.90
|
| Rate for Payer: IEHP Medi-Cal |
$102.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,508.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$942.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,301.25
|
| Rate for Payer: Multiplan Commercial |
$3,903.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,424.25
|
|
