|
HC CREATININE
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$67.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$82.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.61
|
| Rate for Payer: Heritage Provider Network Senior |
$78.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$60.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$85.98
|
| Rate for Payer: Heritage Provider Network Senior |
$85.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
|
|
HC CREATININE CH
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900912181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$46.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.55
|
| Rate for Payer: Heritage Provider Network Senior |
$57.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
|
|
HC CREATININE CH
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900912181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$45.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.71
|
| Rate for Payer: Blue Shield of California Commercial |
$41.24
|
| Rate for Payer: Blue Shield of California EPN |
$33.08
|
| Rate for Payer: Cash Price |
$46.75
|
| Rate for Payer: Cash Price |
$46.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.62
|
| Rate for Payer: Heritage Provider Network Senior |
$52.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.45
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.12
|
| Rate for Payer: TriValley Medical Group Senior |
$5.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE CLEARAN
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$176.70
|
| Rate for Payer: Heritage Provider Network Senior |
$176.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.25
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$139.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.11
|
| Rate for Payer: Blue Shield of California Commercial |
$76.03
|
| Rate for Payer: Blue Shield of California EPN |
$60.98
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$169.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Senior |
$9.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$161.56
|
| Rate for Payer: Heritage Provider Network Senior |
$161.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$124.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.92
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.46
|
| Rate for Payer: TriValley Medical Group Senior |
$9.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$52.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.71
|
| Rate for Payer: Blue Shield of California Commercial |
$41.24
|
| Rate for Payer: Blue Shield of California EPN |
$33.08
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.66
|
| Rate for Payer: Heritage Provider Network Senior |
$60.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.45
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.12
|
| Rate for Payer: TriValley Medical Group Senior |
$5.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$67.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$82.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.61
|
| Rate for Payer: Heritage Provider Network Senior |
$78.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$60.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$85.98
|
| Rate for Payer: Heritage Provider Network Senior |
$85.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$67.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$82.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.61
|
| Rate for Payer: Heritage Provider Network Senior |
$78.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$60.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$95.25 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$85.98
|
| Rate for Payer: Heritage Provider Network Senior |
$85.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.75
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$2,959.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$535.58 |
| Max. Negotiated Rate |
$2,515.15 |
| Rate for Payer: Adventist Health Commercial |
$591.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,581.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,032.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,515.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,627.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,219.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$1,627.45
|
| Rate for Payer: Cash Price |
$1,627.45
|
| Rate for Payer: Cash Price |
$1,627.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,923.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,515.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,515.15
|
| Rate for Payer: Dignity Health Senior |
$2,515.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,923.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,003.24
|
| Rate for Payer: Heritage Provider Network Senior |
$2,003.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,411.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$739.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,071.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,071.30
|
| Rate for Payer: Multiplan Commercial |
$2,219.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,064.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$979.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,515.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,515.15
|
| Rate for Payer: Vantage Medical Group Senior |
$2,515.15
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$2,959.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$535.58 |
| Max. Negotiated Rate |
$2,219.25 |
| Rate for Payer: Adventist Health Commercial |
$591.80
|
| Rate for Payer: Cash Price |
$1,627.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,003.24
|
| Rate for Payer: Heritage Provider Network Senior |
$2,003.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$739.75
|
| Rate for Payer: Multiplan Commercial |
$2,219.25
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$5,893.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$4,549.00 |
| Rate for Payer: Adventist Health Commercial |
$1,178.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,549.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,048.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,070.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$3,241.15
|
| Rate for Payer: Cash Price |
$3,241.15
|
| Rate for Payer: Cash Price |
$3,241.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,830.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,177.68
|
| Rate for Payer: Dignity Health Senior |
$1,070.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,830.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,070.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,989.56
|
| Rate for Payer: Heritage Provider Network Senior |
$3,989.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,070.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,810.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,066.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,231.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,473.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,348.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,348.98
|
| Rate for Payer: Multiplan Commercial |
$4,419.75
|
| Rate for Payer: Multiplan WC |
$1,705.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,120.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,951.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,070.62
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$5,893.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,066.63 |
| Max. Negotiated Rate |
$4,419.75 |
| Rate for Payer: Adventist Health Commercial |
$1,178.60
|
| Rate for Payer: Cash Price |
$3,241.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,989.56
|
| Rate for Payer: Heritage Provider Network Senior |
$3,989.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,066.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,473.25
|
| Rate for Payer: Multiplan Commercial |
$4,419.75
|
|
|
HC CROSSMATCH COMP
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.11
|
| Rate for Payer: Heritage Provider Network Senior |
$182.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.25
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
|
|
HC CROSSMATCH COMP
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$326.60 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$143.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$184.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.44
|
| Rate for Payer: Blue Shield of California Commercial |
$164.09
|
| Rate for Payer: Blue Shield of California EPN |
$131.27
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Cash Price |
$147.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$174.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$166.51
|
| Rate for Payer: Heritage Provider Network Senior |
$166.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$128.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC CROSSMATCH IS
|
Facility
|
IP
|
$686.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.17 |
| Max. Negotiated Rate |
$514.50 |
| Rate for Payer: Adventist Health Commercial |
$137.20
|
| Rate for Payer: Cash Price |
$377.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$464.42
|
| Rate for Payer: Heritage Provider Network Senior |
$464.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.50
|
| Rate for Payer: Multiplan Commercial |
$514.50
|
|
|
HC CROSSMATCH IS
|
Facility
|
OP
|
$686.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$84.46 |
| Max. Negotiated Rate |
$514.50 |
| Rate for Payer: Adventist Health Commercial |
$137.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$366.67
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$471.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$328.58
|
| Rate for Payer: Blue Shield of California Commercial |
$105.02
|
| Rate for Payer: Blue Shield of California EPN |
$84.46
|
| Rate for Payer: Cash Price |
$377.30
|
| Rate for Payer: Cash Price |
$377.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$445.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$445.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$424.63
|
| Rate for Payer: Heritage Provider Network Senior |
$424.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$327.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$514.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC CROSSMATCH XM
|
Facility
|
OP
|
$761.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.47 |
| Max. Negotiated Rate |
$570.75 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$406.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$522.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$328.58
|
| Rate for Payer: Blue Shield of California Commercial |
$56.54
|
| Rate for Payer: Blue Shield of California EPN |
$45.47
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$494.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$471.06
|
| Rate for Payer: Heritage Provider Network Senior |
$471.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$363.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC CROSSMATCH XM
|
Facility
|
IP
|
$761.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$137.74 |
| Max. Negotiated Rate |
$570.75 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Cash Price |
$418.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$515.20
|
| Rate for Payer: Heritage Provider Network Senior |
$515.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.25
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$9,519.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,903.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,539.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,187.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,892.26
|
| Rate for Payer: Heritage Provider Network Senior |
$374.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$579.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,722.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,379.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$7,139.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$335.27
|
| Rate for Payer: TriValley Medical Group Senior |
$335.27
|
| 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 |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$9,519.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,903.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,539.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cash Price |
$5,235.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,187.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,444.36
|
| Rate for Payer: Heritage Provider Network Senior |
$6,444.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,540.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,722.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,379.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$7,139.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,424.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,151.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
