|
HC FINE NDLE ASPIR W/GUIDANCE
|
Facility
|
OP
|
$2,599.00
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
909000240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.79 |
| Max. Negotiated Rate |
$3,517.28 |
| Rate for Payer: Adventist Health Commercial |
$519.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,785.51
|
| 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 |
$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 |
$1,169.55
|
| Rate for Payer: Cash Price |
$1,169.55
|
| Rate for Payer: Cash Price |
$1,169.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,689.35
|
| 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 |
$1,559.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,608.78
|
| Rate for Payer: Heritage Provider Network Senior |
$1,081.26
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,670.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$649.75
|
| 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 |
$1,949.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$966.98
|
| Rate for Payer: TriValley Medical Group Senior |
$966.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| 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 FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$772.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$139.73 |
| Max. Negotiated Rate |
$579.00 |
| Rate for Payer: Adventist Health Commercial |
$154.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$530.36
|
| Rate for Payer: Cash Price |
$347.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$522.64
|
| Rate for Payer: Heritage Provider Network Senior |
$522.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$139.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.00
|
| Rate for Payer: Multiplan Commercial |
$579.00
|
|
|
HC FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$336.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Adventist Health Commercial |
$67.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$154.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$230.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.51
|
| Rate for Payer: Blue Shield of California Commercial |
$208.66
|
| Rate for Payer: Blue Shield of California EPN |
$197.23
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$218.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.47
|
| Rate for Payer: Dignity Health Senior |
$67.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$218.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$207.98
|
| Rate for Payer: Heritage Provider Network Senior |
$207.98
|
| Rate for Payer: Humana Medicare |
$67.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$128.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85.30
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.70
|
| Rate for Payer: TriValley Medical Group Senior |
$67.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Vantage Medical Group Senior |
$67.70
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$43.62 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$165.57
|
| 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 |
$3,237.00
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$156.65
|
| 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 |
$163.16
|
| Rate for Payer: Heritage Provider Network Senior |
$163.16
|
| 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 |
$116.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.25
|
| 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 |
$180.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$87.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$80.52
|
| 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 FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$43.62 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$165.57
|
| 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 |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$149.66
|
| Rate for Payer: Blue Shield of California EPN |
$141.47
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$156.65
|
| 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 |
$149.18
|
| Rate for Payer: Heritage Provider Network Senior |
$149.18
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$114.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.25
|
| 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 |
$180.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$498.20
|
| Rate for Payer: TriValley Medical Group Senior |
$498.20
|
| 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 FINE NEEDLE ASP WO IMAGE
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$95.57 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$362.74
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$357.46
|
| Rate for Payer: Heritage Provider Network Senior |
$357.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$95.57 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$362.74
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$357.46
|
| Rate for Payer: Heritage Provider Network Senior |
$357.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
OP
|
$464.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$54.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$318.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.04
|
| Rate for Payer: Blue Shield of California Commercial |
$83.23
|
| Rate for Payer: Blue Shield of California EPN |
$47.33
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$301.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: Dignity Health Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$287.22
|
| Rate for Payer: Heritage Provider Network Senior |
$287.22
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143.06
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$113.54
|
| Rate for Payer: TriValley Medical Group Senior |
$113.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
IP
|
$464.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$83.98 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$318.77
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$314.13
|
| Rate for Payer: Heritage Provider Network Senior |
$314.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.28 |
| Max. Negotiated Rate |
$241.50 |
| Rate for Payer: Adventist Health Commercial |
$64.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$221.21
|
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$217.99
|
| Rate for Payer: Heritage Provider Network Senior |
$217.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.50
|
| Rate for Payer: Multiplan Commercial |
$241.50
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.63 |
| Max. Negotiated Rate |
$2,190.93 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$116.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$158.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,190.93
|
| Rate for Payer: Blue Shield of California Commercial |
$313.65
|
| Rate for Payer: Blue Shield of California EPN |
$245.20
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$149.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$51.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.37
|
| Rate for Payer: Heritage Provider Network Senior |
$142.37
|
| Rate for Payer: Humana Medicare |
$51.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$97.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.50
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$51.19
|
| Rate for Payer: TriValley Medical Group Senior |
$51.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$55.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.46 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.77
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$147.59
|
| Rate for Payer: Heritage Provider Network Senior |
$147.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$1,752.74 |
| Rate for Payer: Adventist Health Commercial |
$31.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$101.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$107.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,752.74
|
| Rate for Payer: Blue Shield of California Commercial |
$271.84
|
| Rate for Payer: Blue Shield of California EPN |
$212.51
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$102.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Senior |
$42.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$97.18
|
| Rate for Payer: Heritage Provider Network Senior |
$97.18
|
| Rate for Payer: Humana Medicare |
$42.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$52.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$117.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.38
|
| Rate for Payer: TriValley Medical Group Senior |
$42.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.43 |
| Max. Negotiated Rate |
$1,590.45 |
| Rate for Payer: Adventist Health Commercial |
$29.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$93.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$100.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,590.45
|
| Rate for Payer: Blue Shield of California Commercial |
$250.94
|
| Rate for Payer: Blue Shield of California EPN |
$196.17
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$94.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Senior |
$34.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$34.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$90.37
|
| Rate for Payer: Heritage Provider Network Senior |
$90.37
|
| Rate for Payer: Humana Medicare |
$34.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.86
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$34.81
|
| Rate for Payer: TriValley Medical Group Senior |
$34.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.29 |
| Max. Negotiated Rate |
$154.50 |
| Rate for Payer: Adventist Health Commercial |
$41.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$141.52
|
| Rate for Payer: Cash Price |
$92.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$139.46
|
| Rate for Payer: Heritage Provider Network Senior |
$139.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.50
|
| Rate for Payer: Multiplan Commercial |
$154.50
|
|
|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$33.67 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.78
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.92
|
| Rate for Payer: Heritage Provider Network Senior |
$125.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.50
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
|
|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.25 |
| Max. Negotiated Rate |
$1,493.08 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$77.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,493.08
|
| Rate for Payer: Blue Shield of California Commercial |
$209.12
|
| Rate for Payer: Blue Shield of California EPN |
$163.48
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.77
|
| Rate for Payer: Dignity Health Senior |
$40.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$40.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.95
|
| Rate for Payer: Heritage Provider Network Senior |
$82.95
|
| Rate for Payer: Humana Medicare |
$40.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$45.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51.28
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$40.70
|
| Rate for Payer: TriValley Medical Group Senior |
$40.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$43.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$43.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Vantage Medical Group Senior |
$40.70
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.46 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.77
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$147.59
|
| Rate for Payer: Heritage Provider Network Senior |
$147.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.50
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$1,420.05 |
| Rate for Payer: Adventist Health Commercial |
$31.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$62.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$107.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,420.05
|
| Rate for Payer: Blue Shield of California Commercial |
$167.31
|
| Rate for Payer: Blue Shield of California EPN |
$130.79
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$102.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$97.18
|
| Rate for Payer: Heritage Provider Network Senior |
$97.18
|
| Rate for Payer: Humana Medicare |
$21.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.99
|
| Rate for Payer: Multiplan Commercial |
$117.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.42
|
| Rate for Payer: TriValley Medical Group Senior |
$21.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$449.25 |
| Rate for Payer: Adventist Health Commercial |
$119.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$411.51
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$405.52
|
| Rate for Payer: Heritage Provider Network Senior |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.75
|
| Rate for Payer: Multiplan Commercial |
$449.25
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
OP
|
$599.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$119.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$411.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$509.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$329.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| 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 |
$269.55
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$389.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$509.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$509.15
|
| Rate for Payer: Dignity Health Senior |
$509.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$370.78
|
| Rate for Payer: Heritage Provider Network Senior |
$370.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$348.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$288.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.75
|
| Rate for Payer: Multiplan Commercial |
$449.25
|
| 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 |
$509.15
|
| Rate for Payer: Vantage Medical Group Senior |
$509.15
|
|
|
HC FIT & INSERT PESSARY SUPPORT D
|
Facility
|
OP
|
$804.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.11 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$101.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$248.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$522.60
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$248.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Humana Medicare |
$248.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$248.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$387.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| 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 |
$603.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$291.93
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$268.62
|
| 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 FIT & INSERT PESSARY SUPPORT D
|
Facility
|
IP
|
$804.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$603.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| Rate for Payer: Multiplan Commercial |
$603.00
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
IP
|
$5,575.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,009.08 |
| Max. Negotiated Rate |
$4,181.25 |
| Rate for Payer: Adventist Health Commercial |
$1,115.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,830.02
|
| Rate for Payer: Cash Price |
$2,508.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,774.28
|
| Rate for Payer: Heritage Provider Network Senior |
$3,774.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,009.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.75
|
| Rate for Payer: Multiplan Commercial |
$4,181.25
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
OP
|
$5,575.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,115.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,830.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$2,508.75
|
| Rate for Payer: Cash Price |
$2,508.75
|
| Rate for Payer: Cash Price |
$2,508.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,623.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,774.28
|
| Rate for Payer: Heritage Provider Network Senior |
$3,774.28
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,687.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,009.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: Multiplan Commercial |
$4,181.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,024.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,862.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
