|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
OP
|
$7,987.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906811437
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,597.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,487.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,788.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,392.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,990.25
|
| 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 |
$4,392.85
|
| Rate for Payer: Cash Price |
$4,392.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,788.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,788.95
|
| Rate for Payer: Dignity Health Senior |
$6,788.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,943.95
|
| Rate for Payer: Heritage Provider Network Senior |
$4,943.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,809.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,996.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,590.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,590.90
|
| Rate for Payer: Multiplan Commercial |
$5,990.25
|
| 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 |
$6,788.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,788.95
|
| Rate for Payer: Vantage Medical Group Senior |
$6,788.95
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$22,694.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,289.90 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,590.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,481.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,020.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$12,481.70
|
| Rate for Payer: Cash Price |
$12,481.70
|
| Rate for Payer: Cash Price |
$12,481.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,751.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,289.90
|
| Rate for Payer: Dignity Health Senior |
$19,289.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,751.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,047.59
|
| Rate for Payer: Heritage Provider Network Senior |
$14,047.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10,825.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,107.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,885.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,885.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Senior |
$19,289.90
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$26,699.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,832.52 |
| Max. Negotiated Rate |
$20,024.25 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,832.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,674.75
|
| Rate for Payer: Multiplan Commercial |
$20,024.25
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$22,694.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,107.61 |
| Max. Negotiated Rate |
$17,020.50 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Cash Price |
$12,481.70
|
| Rate for Payer: Cash Price |
$12,481.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,107.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.50
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$26,699.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$22,694.15 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,342.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,684.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,024.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$14,684.45
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,354.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,694.15
|
| Rate for Payer: Dignity Health Senior |
$22,694.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,354.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,526.68
|
| Rate for Payer: Heritage Provider Network Senior |
$16,526.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,735.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,832.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,674.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,689.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,689.30
|
| Rate for Payer: Multiplan Commercial |
$20,024.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Senior |
$22,694.15
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$20,918.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,786.16 |
| Max. Negotiated Rate |
$15,688.50 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Cash Price |
$11,504.90
|
| Rate for Payer: Cash Price |
$11,504.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$21,105.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$4,221.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,499.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,720.00
|
| 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 |
$11,607.75
|
| Rate for Payer: Cash Price |
$11,607.75
|
| Rate for Payer: Cash Price |
$11,607.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,064.00
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$782.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,820.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,276.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$15,828.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$14,409.33
|
| 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 |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$23,492.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,252.05 |
| Max. Negotiated Rate |
$17,619.00 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.00
|
| Rate for Payer: Multiplan Commercial |
$17,619.00
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$43,910.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$32,932.50 |
| Rate for Payer: Adventist Health Commercial |
$8,782.00
|
| Rate for Payer: Cash Price |
$24,150.50
|
| Rate for Payer: Cash Price |
$24,150.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,947.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,977.50
|
| Rate for Payer: Multiplan Commercial |
$32,932.50
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$43,910.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$32,932.50 |
| Rate for Payer: Adventist Health Commercial |
$8,782.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,166.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$24,150.50
|
| Rate for Payer: Cash Price |
$24,150.50
|
| Rate for Payer: Cash Price |
$24,150.50
|
| Rate for Payer: Cash Price |
$24,150.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28,541.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,541.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$27,180.29
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,947.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,977.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$32,932.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$14,409.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$23,492.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,139.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,720.00
|
| 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 |
$12,920.60
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,541.55
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$782.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,252.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,873.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$17,619.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$14,409.33
|
| 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 |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$21,105.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,820.01 |
| Max. Negotiated Rate |
$15,828.75 |
| Rate for Payer: Adventist Health Commercial |
$4,221.00
|
| Rate for Payer: Cash Price |
$11,607.75
|
| Rate for Payer: Cash Price |
$11,607.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,820.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,276.25
|
| Rate for Payer: Multiplan Commercial |
$15,828.75
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$20,918.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,370.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$11,504.90
|
| Rate for Payer: Cash Price |
$11,504.90
|
| Rate for Payer: Cash Price |
$11,504.90
|
| Rate for Payer: Cash Price |
$11,504.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,596.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,596.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,948.24
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$14,409.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$7,778.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906820083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$237.67 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,555.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,157.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,343.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,611.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,277.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,833.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$4,277.90
|
| Rate for Payer: Cash Price |
$4,277.90
|
| Rate for Payer: Cash Price |
$4,277.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,611.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,611.30
|
| Rate for Payer: Dignity Health Senior |
$6,611.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,055.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,814.58
|
| Rate for Payer: Heritage Provider Network Senior |
$4,814.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,710.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,407.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,944.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,444.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,444.60
|
| Rate for Payer: Multiplan Commercial |
$5,833.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,611.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,611.30
|
| Rate for Payer: Vantage Medical Group Senior |
$6,611.30
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$6,611.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906812217
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$237.67 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,322.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,533.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,541.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,619.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,636.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$3,636.05
|
| Rate for Payer: Cash Price |
$3,636.05
|
| Rate for Payer: Cash Price |
$3,636.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,619.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,619.35
|
| Rate for Payer: Dignity Health Senior |
$5,619.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,297.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,092.21
|
| Rate for Payer: Heritage Provider Network Senior |
$4,092.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,153.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,196.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,652.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,627.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,627.70
|
| Rate for Payer: Multiplan Commercial |
$4,958.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,619.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,619.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5,619.35
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$7,778.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906820083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,407.82 |
| Max. Negotiated Rate |
$5,833.50 |
| Rate for Payer: Adventist Health Commercial |
$1,555.60
|
| Rate for Payer: Cash Price |
$4,277.90
|
| Rate for Payer: Cash Price |
$4,277.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,407.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,944.50
|
| Rate for Payer: Multiplan Commercial |
$5,833.50
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$6,611.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906812217
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,196.59 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,322.20
|
| Rate for Payer: Cash Price |
$3,636.05
|
| Rate for Payer: Cash Price |
$3,636.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,196.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,652.75
|
| Rate for Payer: Multiplan Commercial |
$4,958.25
|
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
|
IP
|
$14,422.00
|
|
|
Service Code
|
CPT 54435
|
| Hospital Charge Code |
900501751
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,610.38 |
| Max. Negotiated Rate |
$10,816.50 |
| Rate for Payer: Adventist Health Commercial |
$2,884.40
|
| Rate for Payer: Cash Price |
$7,932.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,763.69
|
| Rate for Payer: Heritage Provider Network Senior |
$9,763.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,610.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,605.50
|
| Rate for Payer: Multiplan Commercial |
$10,816.50
|
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
|
OP
|
$14,422.00
|
|
|
Service Code
|
CPT 54435
|
| Hospital Charge Code |
900501751
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,816.50 |
| Rate for Payer: Adventist Health Commercial |
$2,884.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,907.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,820.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,382.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$7,932.10
|
| Rate for Payer: Cash Price |
$7,932.10
|
| Rate for Payer: Cash Price |
$7,932.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,374.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,820.49
|
| Rate for Payer: Dignity Health Senior |
$4,382.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,382.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,763.69
|
| Rate for Payer: Heritage Provider Network Senior |
$9,763.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,382.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,610.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,039.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,605.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.65
|
| Rate for Payer: Multiplan Commercial |
$10,816.50
|
| Rate for Payer: Multiplan WC |
$6,982.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5,189.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4,775.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,820.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,382.26
|
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
|
IP
|
$1,719.00
|
|
|
Service Code
|
CPT 74445
|
| Hospital Charge Code |
909080040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$311.14 |
| Max. Negotiated Rate |
$1,289.25 |
| Rate for Payer: Adventist Health Commercial |
$343.80
|
| Rate for Payer: Cash Price |
$945.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,163.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,163.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.75
|
| Rate for Payer: Multiplan Commercial |
$1,289.25
|
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
|
OP
|
$1,719.00
|
|
|
Service Code
|
CPT 74445
|
| Hospital Charge Code |
909080040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.09 |
| Max. Negotiated Rate |
$1,289.25 |
| Rate for Payer: Adventist Health Commercial |
$343.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$918.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,180.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$296.44
|
| Rate for Payer: Blue Shield of California Commercial |
$236.93
|
| Rate for Payer: Blue Shield of California EPN |
$190.53
|
| Rate for Payer: Cash Price |
$945.45
|
| Rate for Payer: Cash Price |
$945.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,117.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,117.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,064.06
|
| Rate for Payer: Heritage Provider Network Senior |
$1,064.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$819.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,289.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$294.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$294.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC CORTISOL
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.58 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Cash Price |
$162.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$200.39
|
| Rate for Payer: Heritage Provider Network Senior |
$200.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.00
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
|
|
HC CORTISOL
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$158.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$203.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.99
|
| Rate for Payer: Blue Shield of California Commercial |
$131.21
|
| Rate for Payer: Blue Shield of California EPN |
$105.24
|
| Rate for Payer: Cash Price |
$162.80
|
| Rate for Payer: Cash Price |
$162.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$192.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.93
|
| Rate for Payer: Dignity Health Senior |
$16.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.22
|
| Rate for Payer: Heritage Provider Network Senior |
$183.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$141.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.54
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.30
|
| Rate for Payer: TriValley Medical Group Senior |
$16.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
|
HC COUGH ASSIST
|
Facility
|
IP
|
$369.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801124
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$276.75 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$249.81
|
| Rate for Payer: Heritage Provider Network Senior |
$249.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.25
|
| Rate for Payer: Multiplan Commercial |
$276.75
|
|
|
HC COUGH ASSIST
|
Facility
|
OP
|
$369.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801124
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$298.20 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$197.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$253.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Blue Shield of California Commercial |
$225.09
|
| Rate for Payer: Blue Shield of California EPN |
$180.07
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$239.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Senior |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$228.41
|
| Rate for Payer: Heritage Provider Network Senior |
$228.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$176.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$250.49
|
| Rate for Payer: Multiplan Commercial |
$276.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$218.68
|
| Rate for Payer: TriValley Medical Group Senior |
$198.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$184.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$184.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
