|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
IP
|
$1,324.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$239.64 |
| Max. Negotiated Rate |
$993.00 |
| Rate for Payer: Adventist Health Commercial |
$264.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$909.59
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$896.35
|
| Rate for Payer: Heritage Provider Network Senior |
$896.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.00
|
| Rate for Payer: Multiplan Commercial |
$993.00
|
|
|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
OP
|
$1,324.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$62.32 |
| Max. Negotiated Rate |
$1,125.40 |
| Rate for Payer: Adventist Health Commercial |
$264.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$264.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$909.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,125.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$728.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$993.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$860.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,125.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,125.40
|
| Rate for Payer: Dignity Health Senior |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$860.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$819.56
|
| Rate for Payer: Heritage Provider Network Senior |
$819.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$62.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$638.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.00
|
| Rate for Payer: Multiplan Commercial |
$993.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,125.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,125.40
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$433.50 |
| Rate for Payer: Adventist Health Commercial |
$102.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$227.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$350.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$433.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$280.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$382.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$331.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$433.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$433.50
|
| Rate for Payer: Dignity Health Senior |
$433.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$315.69
|
| Rate for Payer: Heritage Provider Network Senior |
$315.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$127.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$245.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.50
|
| Rate for Payer: Multiplan Commercial |
$382.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$433.50
|
| Rate for Payer: Vantage Medical Group Senior |
$433.50
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Adventist Health Commercial |
$102.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$350.37
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$345.27
|
| Rate for Payer: Heritage Provider Network Senior |
$345.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.50
|
| Rate for Payer: Multiplan Commercial |
$382.50
|
|
|
HC EVASC ST RPR THRC/AA ACRS BR
|
Facility
|
OP
|
$5,013.00
|
|
|
Service Code
|
CPT 33894
|
| Hospital Charge Code |
906820288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$251.49 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,443.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,757.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,759.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| 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 |
$2,255.85
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,258.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,261.05
|
| Rate for Payer: Dignity Health Senior |
$4,261.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,103.05
|
| Rate for Payer: Heritage Provider Network Senior |
$3,103.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$251.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,416.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.25
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
| 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 Medi-Cal |
$4,261.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,261.05
|
|
|
HC EVASC ST RPR THRC/AA ACRS BR
|
Facility
|
IP
|
$5,013.00
|
|
|
Service Code
|
CPT 33894
|
| Hospital Charge Code |
906820288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.35 |
| Max. Negotiated Rate |
$3,759.75 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,443.93
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,393.80
|
| Rate for Payer: Heritage Provider Network Senior |
$3,393.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.25
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
|
|
HC EVASC ST RPR THRC/AA NO CRSG BR
|
Facility
|
OP
|
$5,013.00
|
|
|
Service Code
|
CPT 33895
|
| Hospital Charge Code |
906820289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.35 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,443.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,757.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,759.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| 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 |
$2,255.85
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,258.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,261.05
|
| Rate for Payer: Dignity Health Senior |
$4,261.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,103.05
|
| Rate for Payer: Heritage Provider Network Senior |
$3,103.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,001.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,416.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.25
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
| 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 Medi-Cal |
$4,261.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,261.05
|
|
|
HC EVASC ST RPR THRC/AA NO CRSG BR
|
Facility
|
IP
|
$5,013.00
|
|
|
Service Code
|
CPT 33895
|
| Hospital Charge Code |
906820289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.35 |
| Max. Negotiated Rate |
$3,759.75 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,443.93
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,393.80
|
| Rate for Payer: Heritage Provider Network Senior |
$3,393.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.25
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
|
|
HC EV FEM POP ARTERIAL REVASC
|
Facility
|
IP
|
$25,921.00
|
|
|
Service Code
|
CPT 0505T
|
| Hospital Charge Code |
909000505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,691.70 |
| Max. Negotiated Rate |
$19,440.75 |
| Rate for Payer: Adventist Health Commercial |
$5,184.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,807.73
|
| Rate for Payer: Cash Price |
$11,664.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,548.52
|
| Rate for Payer: Heritage Provider Network Senior |
$17,548.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,691.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,480.25
|
| Rate for Payer: Multiplan Commercial |
$19,440.75
|
|
|
HC EV FEM POP ARTERIAL REVASC
|
Facility
|
OP
|
$25,921.00
|
|
|
Service Code
|
CPT 0505T
|
| Hospital Charge Code |
909000505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$5,184.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,807.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$11,664.45
|
| Rate for Payer: Cash Price |
$11,664.45
|
| Rate for Payer: Cash Price |
$11,664.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,848.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,045.10
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,691.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,480.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$19,440.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC EV VEN ATLIZTN TBL OR PRL VEIN
|
Facility
|
IP
|
$42,025.00
|
|
|
Service Code
|
CPT 0620T
|
| Hospital Charge Code |
909000620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,606.52 |
| Max. Negotiated Rate |
$31,518.75 |
| Rate for Payer: Adventist Health Commercial |
$8,405.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,871.18
|
| Rate for Payer: Cash Price |
$18,911.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$28,450.92
|
| Rate for Payer: Heritage Provider Network Senior |
$28,450.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,606.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,506.25
|
| Rate for Payer: Multiplan Commercial |
$31,518.75
|
|
|
HC EV VEN ATLIZTN TBL OR PRL VEIN
|
Facility
|
OP
|
$42,025.00
|
|
|
Service Code
|
CPT 0620T
|
| Hospital Charge Code |
909000620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$68,518.77 |
| Rate for Payer: Adventist Health Commercial |
$8,405.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,871.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54,093.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39,668.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,062.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$18,911.25
|
| Rate for Payer: Cash Price |
$18,911.25
|
| Rate for Payer: Cash Price |
$18,911.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27,316.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54,093.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$39,668.76
|
| Rate for Payer: Dignity Health Senior |
$36,062.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$36,062.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$26,013.48
|
| Rate for Payer: Heritage Provider Network Senior |
$44,356.89
|
| Rate for Payer: Humana Medicare |
$36,062.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,062.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$68,518.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,606.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,553.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,506.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,438.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,438.76
|
| Rate for Payer: Multiplan Commercial |
$31,518.75
|
| Rate for Payer: Multiplan WC |
$31,747.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$39,668.76
|
| Rate for Payer: TriValley Medical Group Senior |
$39,668.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54,093.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39,668.76
|
| Rate for Payer: Vantage Medical Group Senior |
$36,062.51
|
|
|
HC EWHO COMB HUMERAL RADIUS ULNAR WRIS
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT L3763
|
| Hospital Charge Code |
903203986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$190.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$272.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$336.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$297.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$245.92
|
| Rate for Payer: Blue Shield of California EPN |
$232.45
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$182.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$336.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.60
|
| Rate for Payer: Dignity Health Senior |
$336.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.35
|
| Rate for Payer: Heritage Provider Network Senior |
$183.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,144.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.00
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$144.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$132.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.60
|
| Rate for Payer: Vantage Medical Group Senior |
$336.60
|
|
|
HC EWHO COMB HUMERAL RADIUS ULNAR WRIS
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT L3763
|
| Hospital Charge Code |
903203986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$190.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$272.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$182.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.09
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.00
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$144.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$132.30
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
OP
|
$1,483.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$268.42 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$296.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,018.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$667.35
|
| Rate for Payer: Cash Price |
$667.35
|
| Rate for Payer: Cash Price |
$667.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$963.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: Dignity Health Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,003.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,003.99
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$714.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,107.63
|
| Rate for Payer: Multiplan Commercial |
$1,112.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$538.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$495.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
IP
|
$1,483.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$268.42 |
| Max. Negotiated Rate |
$1,112.25 |
| Rate for Payer: Adventist Health Commercial |
$296.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,018.82
|
| Rate for Payer: Cash Price |
$667.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,003.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,003.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.75
|
| Rate for Payer: Multiplan Commercial |
$1,112.25
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$341.37 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$377.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,295.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,225.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: Dignity Health Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,276.82
|
| Rate for Payer: Heritage Provider Network Senior |
$1,276.82
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$909.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,107.63
|
| Rate for Payer: Multiplan Commercial |
$1,414.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$684.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$630.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
IP
|
$1,886.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$341.37 |
| Max. Negotiated Rate |
$1,414.50 |
| Rate for Payer: Adventist Health Commercial |
$377.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,295.68
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,276.82
|
| Rate for Payer: Heritage Provider Network Senior |
$1,276.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.50
|
| Rate for Payer: Multiplan Commercial |
$1,414.50
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
OP
|
$1,926.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$385.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,323.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,251.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,303.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,303.90
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$928.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$1,444.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$699.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$643.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$1,926.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$1,444.50 |
| Rate for Payer: Adventist Health Commercial |
$385.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,323.16
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,303.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,303.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.50
|
| Rate for Payer: Multiplan Commercial |
$1,444.50
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
IP
|
$3,474.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$628.79 |
| Max. Negotiated Rate |
$2,605.50 |
| Rate for Payer: Adventist Health Commercial |
$694.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,386.64
|
| Rate for Payer: Cash Price |
$1,563.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,351.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,351.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$628.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$868.50
|
| Rate for Payer: Multiplan Commercial |
$2,605.50
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
OP
|
$3,474.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$628.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$694.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,386.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,563.30
|
| Rate for Payer: Cash Price |
$1,563.30
|
| Rate for Payer: Cash Price |
$1,563.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,258.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,351.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,351.90
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,674.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$628.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$868.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$2,605.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,261.41
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,160.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
OP
|
$1,246.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.53 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$249.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$856.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$809.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$843.54
|
| Rate for Payer: Heritage Provider Network Senior |
$843.54
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$600.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$934.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$452.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$416.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.53 |
| Max. Negotiated Rate |
$934.50 |
| Rate for Payer: Adventist Health Commercial |
$249.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$856.00
|
| Rate for Payer: Cash Price |
$560.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$843.54
|
| Rate for Payer: Heritage Provider Network Senior |
$843.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.50
|
| Rate for Payer: Multiplan Commercial |
$934.50
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$1,128.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.17 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$225.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$774.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$733.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: Dignity Health Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$763.66
|
| Rate for Payer: Heritage Provider Network Senior |
$763.66
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$543.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,107.63
|
| Rate for Payer: Multiplan Commercial |
$846.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$409.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$376.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
