|
HC CELL COUNT & DIFF
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
900910124
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$46.15 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.15
|
| Rate for Payer: Blue Shield of California Commercial |
$43.04
|
| Rate for Payer: Blue Shield of California EPN |
$33.65
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.16
|
| Rate for Payer: Dignity Health Senior |
$5.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.00
|
| Rate for Payer: Heritage Provider Network Senior |
$13.00
|
| Rate for Payer: Humana Medicare |
$5.60
|
| Rate for Payer: IEHP Medi-Cal |
$7.58
|
| Rate for Payer: IEHP Medicare Advantage |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.06
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.60
|
| Rate for Payer: TriValley Medical Group Senior |
$5.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.05
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.16
|
| Rate for Payer: Vantage Medical Group Senior |
$5.60
|
|
|
HC CELL EXPANSION
|
Facility
OP
|
$426.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900918001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$1,099.16 |
| Rate for Payer: Adventist Health Commercial |
$85.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$409.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$292.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$999.95
|
| Rate for Payer: Blue Shield of California Commercial |
$1,099.16
|
| Rate for Payer: Blue Shield of California EPN |
$859.27
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$276.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: Dignity Health Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$140.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$263.69
|
| Rate for Payer: Heritage Provider Network Senior |
$263.69
|
| Rate for Payer: Humana Medicare |
$140.73
|
| Rate for Payer: IEHP Medi-Cal |
$195.12
|
| Rate for Payer: IEHP Medicare Advantage |
$140.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$267.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$166.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$177.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$177.32
|
| Rate for Payer: Multiplan Commercial |
$319.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$140.73
|
| Rate for Payer: TriValley Medical Group Senior |
$140.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.99
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC CELL EXPANSION
|
Facility
IP
|
$393.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900918001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$71.13 |
| Max. Negotiated Rate |
$294.75 |
| Rate for Payer: Adventist Health Commercial |
$78.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$269.99
|
| Rate for Payer: Cash Price |
$176.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$266.06
|
| Rate for Payer: Heritage Provider Network Senior |
$266.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.25
|
| Rate for Payer: Multiplan Commercial |
$294.75
|
|
|
HC CELL MORPHOLOGY (VISUAL)
|
Facility
IP
|
$131.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900910073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.71 |
| Max. Negotiated Rate |
$98.25 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$90.00
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$88.69
|
| Rate for Payer: Heritage Provider Network Senior |
$88.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.75
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
|
|
HC CELL MORPHOLOGY (VISUAL)
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900910073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.80
|
| Rate for Payer: Blue Shield of California Commercial |
$26.89
|
| Rate for Payer: Blue Shield of California EPN |
$21.02
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Senior |
$3.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$3.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.05
|
| Rate for Payer: Heritage Provider Network Senior |
$8.05
|
| Rate for Payer: Humana Medicare |
$3.80
|
| Rate for Payer: IEHP Medi-Cal |
$4.23
|
| Rate for Payer: IEHP Medicare Advantage |
$3.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.80
|
| Rate for Payer: TriValley Medical Group Senior |
$3.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$3.80
|
|
|
HC CELL MORPHOLOGY VISUAL INDIVIDUAL
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900912021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.80
|
| Rate for Payer: Blue Shield of California Commercial |
$26.89
|
| Rate for Payer: Blue Shield of California EPN |
$21.02
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Senior |
$3.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$3.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.05
|
| Rate for Payer: Heritage Provider Network Senior |
$8.05
|
| Rate for Payer: Humana Medicare |
$3.80
|
| Rate for Payer: IEHP Medi-Cal |
$4.23
|
| Rate for Payer: IEHP Medicare Advantage |
$3.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.80
|
| Rate for Payer: TriValley Medical Group Senior |
$3.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$3.80
|
|
|
HC CELL MORPHOLOGY VISUAL INDIVIDUAL
|
Facility
IP
|
$131.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900912021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.71 |
| Max. Negotiated Rate |
$98.25 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$90.00
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$88.69
|
| Rate for Payer: Heritage Provider Network Senior |
$88.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.75
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
|
|
HC CENTROMERE AB
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$100.92 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.92
|
| Rate for Payer: Blue Shield of California Commercial |
$94.14
|
| Rate for Payer: Blue Shield of California EPN |
$73.59
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Humana Medicare |
$12.05
|
| Rate for Payer: IEHP Medi-Cal |
$13.46
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC CENTROMERE AB
|
Facility
IP
|
$162.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.32 |
| Max. Negotiated Rate |
$121.50 |
| Rate for Payer: Adventist Health Commercial |
$32.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.29
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$109.67
|
| Rate for Payer: Heritage Provider Network Senior |
$109.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
IP
|
$1,378.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$249.42 |
| Max. Negotiated Rate |
$1,033.50 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$946.69
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$932.91
|
| Rate for Payer: Heritage Provider Network Senior |
$932.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.50
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
OP
|
$1,378.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$1,283.13 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$360.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$946.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Blue Shield of California Commercial |
$323.87
|
| Rate for Payer: Blue Shield of California EPN |
$184.18
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$895.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.86
|
| Rate for Payer: Dignity Health Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$895.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$675.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$852.98
|
| Rate for Payer: Heritage Provider Network Senior |
$852.98
|
| Rate for Payer: Humana Medicare |
$675.33
|
| Rate for Payer: IEHP Medi-Cal |
$62.74
|
| Rate for Payer: IEHP Medicare Advantage |
$675.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,283.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$850.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$850.92
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$742.86
|
| Rate for Payer: TriValley Medical Group Senior |
$675.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC CERULOPLASMIN
|
Facility
IP
|
$138.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.98 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$94.81
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$93.43
|
| Rate for Payer: Heritage Provider Network Senior |
$93.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
|
|
HC CERULOPLASMIN
|
Facility
OP
|
$31.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$89.88 |
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.88
|
| Rate for Payer: Blue Shield of California Commercial |
$83.91
|
| Rate for Payer: Blue Shield of California EPN |
$65.59
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Senior |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.19
|
| Rate for Payer: Heritage Provider Network Senior |
$19.19
|
| Rate for Payer: Humana Medicare |
$10.74
|
| Rate for Payer: IEHP Medi-Cal |
$14.90
|
| Rate for Payer: IEHP Medicare Advantage |
$10.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.53
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.74
|
| Rate for Payer: TriValley Medical Group Senior |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
IP
|
$44.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.23
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.79
|
| Rate for Payer: Heritage Provider Network Senior |
$29.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
OP
|
$44.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$2,869.00 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$248.97
|
| Rate for Payer: Blue Shield of California Commercial |
$27.32
|
| Rate for Payer: Blue Shield of California EPN |
$25.83
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$273.87
|
| Rate for Payer: Dignity Health Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$248.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.24
|
| Rate for Payer: Heritage Provider Network Senior |
$27.24
|
| Rate for Payer: Humana Medicare |
$248.97
|
| Rate for Payer: IEHP Medicare Advantage |
$248.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$473.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$313.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$313.70
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.00
|
| Rate for Payer: TriValley Medical Group Senior |
$22.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
IP
|
$44.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.23
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.79
|
| Rate for Payer: Heritage Provider Network Senior |
$29.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
OP
|
$44.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$2,869.00 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$248.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$273.87
|
| Rate for Payer: Dignity Health Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$248.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.79
|
| Rate for Payer: Heritage Provider Network Senior |
$29.79
|
| Rate for Payer: Humana Medicare |
$248.97
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$248.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$313.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$313.70
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$194.21 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
| Rate for Payer: Adventist Health Commercial |
$214.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$737.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$666.33
|
| Rate for Payer: Blue Shield of California EPN |
$629.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$697.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: Dignity Health Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$400.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$664.19
|
| Rate for Payer: Heritage Provider Network Senior |
$664.19
|
| Rate for Payer: Humana Medicare |
$400.82
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$761.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$472.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$268.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$505.03
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$440.90
|
| Rate for Payer: TriValley Medical Group Senior |
$400.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$194.21 |
| Max. Negotiated Rate |
$804.75 |
| Rate for Payer: Adventist Health Commercial |
$214.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$737.15
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$726.42
|
| Rate for Payer: Heritage Provider Network Senior |
$726.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$268.25
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
IP
|
$1,197.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.66 |
| Max. Negotiated Rate |
$897.75 |
| Rate for Payer: Adventist Health Commercial |
$239.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$822.34
|
| Rate for Payer: Cash Price |
$538.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$810.37
|
| Rate for Payer: Heritage Provider Network Senior |
$810.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.25
|
| Rate for Payer: Multiplan Commercial |
$897.75
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
OP
|
$1,197.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.66 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$239.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$822.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,017.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$658.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$897.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$538.65
|
| Rate for Payer: Cash Price |
$538.65
|
| Rate for Payer: Cash Price |
$538.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$778.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,017.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,017.45
|
| Rate for Payer: Dignity Health Senior |
$1,017.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$718.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$740.94
|
| Rate for Payer: Heritage Provider Network Senior |
$740.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$576.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.25
|
| Rate for Payer: Multiplan Commercial |
$897.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,017.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,017.45
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
IP
|
$6,880.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,245.28 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,376.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,726.56
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,657.76
|
| Rate for Payer: Heritage Provider Network Senior |
$4,657.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,245.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,720.00
|
| Rate for Payer: Multiplan Commercial |
$5,160.00
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
OP
|
$6,880.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.48 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,376.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,726.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,472.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: Dignity Health Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,128.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$370.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,258.72
|
| Rate for Payer: Heritage Provider Network Senior |
$455.17
|
| Rate for Payer: Humana Medicare |
$370.06
|
| Rate for Payer: IEHP Medi-Cal |
$118.48
|
| Rate for Payer: IEHP Medicare Advantage |
$370.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$703.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,245.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$436.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,720.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.28
|
| Rate for Payer: Multiplan Commercial |
$5,160.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$407.07
|
| Rate for Payer: TriValley Medical Group Senior |
$407.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC CERVICAL PUNCTURE FOR MYELO
|
Facility
IP
|
$1,586.00
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
909000179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.07 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Adventist Health Commercial |
$317.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,089.58
|
| Rate for Payer: Cash Price |
$713.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,073.72
|
| Rate for Payer: Heritage Provider Network Senior |
$1,073.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.50
|
| Rate for Payer: Multiplan Commercial |
$1,189.50
|
|
|
HC CERVICAL PUNCTURE FOR MYELO
|
Facility
OP
|
$1,586.00
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
909000179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.69 |
| Max. Negotiated Rate |
$3,517.28 |
| Rate for Payer: Adventist Health Commercial |
$317.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,089.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$713.70
|
| Rate for Payer: Cash Price |
$713.70
|
| Rate for Payer: Cash Price |
$713.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,030.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: Dignity Health Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$951.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$370.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$981.73
|
| Rate for Payer: Heritage Provider Network Senior |
$455.17
|
| Rate for Payer: Humana Medicare |
$370.06
|
| Rate for Payer: IEHP Medi-Cal |
$220.69
|
| Rate for Payer: IEHP Medicare Advantage |
$370.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$703.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$436.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.28
|
| Rate for Payer: Multiplan Commercial |
$1,189.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$407.07
|
| Rate for Payer: TriValley Medical Group Senior |
$407.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
