|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$10,153.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,975.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$5,584.15
|
| Rate for Payer: Cash Price |
$5,584.15
|
| Rate for Payer: Cash Price |
$5,584.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,599.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,284.71
|
| Rate for Payer: Heritage Provider Network Senior |
$8,448.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$416.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,050.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,837.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$7,614.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,555.33
|
| Rate for Payer: TriValley Medical Group Senior |
$7,555.33
|
| 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 |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
OP
|
$9,646.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
909020145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,929.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,626.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$5,305.30
|
| Rate for Payer: Cash Price |
$5,305.30
|
| Rate for Payer: Cash Price |
$5,305.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,269.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,970.87
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$385.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,745.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,411.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| 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 |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
IP
|
$9,646.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
909020145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,745.93 |
| Max. Negotiated Rate |
$7,234.50 |
| Rate for Payer: Adventist Health Commercial |
$1,929.20
|
| Rate for Payer: Cash Price |
$5,305.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,530.34
|
| Rate for Payer: Heritage Provider Network Senior |
$6,530.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,745.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,411.50
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
OP
|
$9,375.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
906820220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,875.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,440.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$5,156.25
|
| Rate for Payer: Cash Price |
$5,156.25
|
| Rate for Payer: Cash Price |
$5,156.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,093.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,803.12
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$385.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,696.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$7,031.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| 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 |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
IP
|
$9,375.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
906820220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,696.88 |
| Max. Negotiated Rate |
$7,031.25 |
| Rate for Payer: Adventist Health Commercial |
$1,875.00
|
| Rate for Payer: Cash Price |
$5,156.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,346.88
|
| Rate for Payer: Heritage Provider Network Senior |
$6,346.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,696.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.75
|
| Rate for Payer: Multiplan Commercial |
$7,031.25
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN MCAL
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
901300068
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$45.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$75.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$71.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.50
|
| Rate for Payer: Dignity Health Senior |
$93.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.09
|
| Rate for Payer: Heritage Provider Network Senior |
$68.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Vantage Medical Group Senior |
$93.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN MCAL
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
901300068
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.47
|
| Rate for Payer: Heritage Provider Network Senior |
$74.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN OT
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905104153
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$45.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$75.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$71.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.50
|
| Rate for Payer: Dignity Health Senior |
$93.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.09
|
| Rate for Payer: Heritage Provider Network Senior |
$68.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Vantage Medical Group Senior |
$93.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN OT
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905104153
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.47
|
| Rate for Payer: Heritage Provider Network Senior |
$74.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905103153
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$45.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$75.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$71.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.50
|
| Rate for Payer: Dignity Health Senior |
$93.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.09
|
| Rate for Payer: Heritage Provider Network Senior |
$68.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Vantage Medical Group Senior |
$93.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905103153
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.47
|
| Rate for Payer: Heritage Provider Network Senior |
$74.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT COMM MCARE
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
900417537
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.47
|
| Rate for Payer: Heritage Provider Network Senior |
$74.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT COMM MCARE
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
900417537
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$45.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$75.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$71.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.50
|
| Rate for Payer: Dignity Health Senior |
$93.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.09
|
| Rate for Payer: Heritage Provider Network Senior |
$68.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Vantage Medical Group Senior |
$93.50
|
|
|
HC COMPLEMENT C-3
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
900910841
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.46 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$147.59
|
| Rate for Payer: Heritage Provider Network Senior |
$147.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
|
|
HC COMPLEMENT C-3
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
900910841
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$116.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.59
|
| Rate for Payer: Blue Shield of California Commercial |
$96.65
|
| Rate for Payer: Blue Shield of California EPN |
$77.52
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$141.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.20
|
| Rate for Payer: Dignity Health Senior |
$12.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$134.94
|
| Rate for Payer: Heritage Provider Network Senior |
$134.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Vantage Medical Group Senior |
$12.00
|
|
|
HC COMPLEMENT C-4
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
900910979
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.46 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$147.59
|
| Rate for Payer: Heritage Provider Network Senior |
$147.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
|
|
HC COMPLEMENT C-4
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
900910979
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$116.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.59
|
| Rate for Payer: Blue Shield of California Commercial |
$96.65
|
| Rate for Payer: Blue Shield of California EPN |
$77.52
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Cash Price |
$119.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$141.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.20
|
| Rate for Payer: Dignity Health Senior |
$12.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$134.94
|
| Rate for Payer: Heritage Provider Network Senior |
$134.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Vantage Medical Group Senior |
$12.00
|
|
|
HC COMPLEMENT TOTAL
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
900910842
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$185.43 |
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$74.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$185.43
|
| Rate for Payer: Blue Shield of California Commercial |
$163.53
|
| Rate for Payer: Blue Shield of California EPN |
$131.16
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$70.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.35
|
| Rate for Payer: Dignity Health Senior |
$20.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.47
|
| Rate for Payer: Heritage Provider Network Senior |
$67.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$51.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.32
|
| Rate for Payer: TriValley Medical Group Senior |
$20.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20.32
|
|
|
HC COMPLEMENT TOTAL
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
900910842
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$81.75 |
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.79
|
| Rate for Payer: Heritage Provider Network Senior |
$73.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.25
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
|
|
HC COMPLEX PUSHABLE COIL
|
Facility
|
IP
|
$370.00
|
|
| Hospital Charge Code |
909081803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$177.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$148.74
|
| Rate for Payer: Blue Shield of California EPN |
$148.74
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$185.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$185.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
|
|
HC COMPLEX PUSHABLE COIL
|
Facility
|
OP
|
$370.00
|
|
| Hospital Charge Code |
909081803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$177.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$254.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$148.74
|
| Rate for Payer: Blue Shield of California EPN |
$148.74
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.50
|
| Rate for Payer: Dignity Health Senior |
$314.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$185.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$185.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$259.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$259.00
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.50
|
| Rate for Payer: Vantage Medical Group Senior |
$314.50
|
|
|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
|
OP
|
$795.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$596.25 |
| Rate for Payer: Adventist Health Commercial |
$159.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$424.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$546.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.62
|
| Rate for Payer: Blue Shield of California Commercial |
$85.08
|
| Rate for Payer: Blue Shield of California EPN |
$68.24
|
| Rate for Payer: Cash Price |
$437.25
|
| Rate for Payer: Cash Price |
$437.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$516.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.62
|
| Rate for Payer: Dignity Health Senior |
$10.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$516.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$492.11
|
| Rate for Payer: Heritage Provider Network Senior |
$492.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$379.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.31
|
| Rate for Payer: Multiplan Commercial |
$596.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.56
|
| Rate for Payer: TriValley Medical Group Senior |
$10.56
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
|
|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
|
IP
|
$795.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$143.90 |
| Max. Negotiated Rate |
$596.25 |
| Rate for Payer: Adventist Health Commercial |
$159.00
|
| Rate for Payer: Cash Price |
$437.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$538.22
|
| Rate for Payer: Heritage Provider Network Senior |
$538.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.75
|
| Rate for Payer: Multiplan Commercial |
$596.25
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
|
IP
|
$351.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$63.53 |
| Max. Negotiated Rate |
$263.25 |
| Rate for Payer: Adventist Health Commercial |
$70.20
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$237.63
|
| Rate for Payer: Heritage Provider Network Senior |
$237.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.75
|
| Rate for Payer: Multiplan Commercial |
$263.25
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
|
OP
|
$351.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$63.53 |
| Max. Negotiated Rate |
$610.61 |
| Rate for Payer: Adventist Health Commercial |
$70.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$187.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Blue Shield of California Commercial |
$610.61
|
| Rate for Payer: Blue Shield of California EPN |
$491.03
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$228.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$217.27
|
| Rate for Payer: Heritage Provider Network Senior |
$217.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$167.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$263.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$180.16
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$522.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
