|
HC CL TREAT OF CLAV FRAC W/MANIPU
|
Facility
|
OP
|
$4,233.00
|
|
|
Service Code
|
CPT 23505
|
| Hospital Charge Code |
900501357
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$766.17 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$846.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,615.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,010.67
|
| Rate for Payer: Blue Shield of California EPN |
$1,600.07
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,751.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,865.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,865.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,019.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$766.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,174.75
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,539.80
|
| Rate for Payer: TriValley Medical Group Senior |
$2,539.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF CLAV FRAC W/MANIPU
|
Facility
|
IP
|
$4,233.00
|
|
|
Service Code
|
CPT 23505
|
| Hospital Charge Code |
900501357
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$766.17 |
| Max. Negotiated Rate |
$3,174.75 |
| Rate for Payer: Adventist Health Commercial |
$846.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,726.05
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,865.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,865.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$766.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.25
|
| Rate for Payer: Multiplan Commercial |
$3,174.75
|
|
|
HC CL TREAT OF CLAV FRAC W/O MANI
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
900501058
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$694.88
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT OF CLAV FRAC W/O MANI
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
900501058
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$666.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$512.52
|
| Rate for Payer: Blue Shield of California EPN |
$407.86
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$317.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$514.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$647.40
|
| Rate for Payer: TriValley Medical Group Senior |
$647.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT OF DIS RAD FRAC W/MAN
|
Facility
|
OP
|
$2,068.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.31 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$413.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,278.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$982.30
|
| Rate for Payer: Blue Shield of California EPN |
$781.70
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,344.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,400.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,400.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$986.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$374.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$1,551.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,240.80
|
| Rate for Payer: TriValley Medical Group Senior |
$1,240.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF DIS RAD FRAC W/MAN
|
Facility
|
IP
|
$2,068.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.31 |
| Max. Negotiated Rate |
$1,551.00 |
| Rate for Payer: Adventist Health Commercial |
$413.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,331.79
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,400.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,400.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$374.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.00
|
| Rate for Payer: Multiplan Commercial |
$1,551.00
|
|
|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$694.88
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$666.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$512.52
|
| Rate for Payer: Blue Shield of California EPN |
$407.86
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$317.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$514.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$647.40
|
| Rate for Payer: TriValley Medical Group Senior |
$647.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
|
OP
|
$3,682.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$666.44 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$736.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,275.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,748.95
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.80
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,393.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.71
|
| Rate for Payer: Heritage Provider Network Senior |
$2,492.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,756.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$666.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$920.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$2,761.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,209.20
|
| Rate for Payer: TriValley Medical Group Senior |
$2,209.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
|
IP
|
$3,682.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$666.44 |
| Max. Negotiated Rate |
$2,761.50 |
| Rate for Payer: Adventist Health Commercial |
$736.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,371.21
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.71
|
| Rate for Payer: Heritage Provider Network Senior |
$2,492.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$666.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$920.50
|
| Rate for Payer: Multiplan Commercial |
$2,761.50
|
|
|
HC CL TREAT OF ELBOW FRAC W/MANIP
|
Facility
|
OP
|
$3,994.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
900501359
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.91 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Cash Price |
$1,797.30
|
| Rate for Payer: Adventist Health Commercial |
$798.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,468.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,897.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,509.73
|
| Rate for Payer: Cash Price |
$1,797.30
|
| Rate for Payer: Cash Price |
$1,797.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,596.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,703.94
|
| Rate for Payer: Heritage Provider Network Senior |
$2,703.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,905.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$722.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$2,995.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,396.40
|
| Rate for Payer: TriValley Medical Group Senior |
$2,396.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF ELBOW FRAC W/MANIP
|
Facility
|
IP
|
$3,994.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
900501359
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.91 |
| Max. Negotiated Rate |
$2,995.50 |
| Rate for Payer: Adventist Health Commercial |
$798.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,572.14
|
| Rate for Payer: Cash Price |
$1,797.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,703.94
|
| Rate for Payer: Heritage Provider Network Senior |
$2,703.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$722.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.50
|
| Rate for Payer: Multiplan Commercial |
$2,995.50
|
|
|
HC CL TREAT OF FRAC OF PHAL W/MAN
|
Facility
|
OP
|
$1,319.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$238.74 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$263.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$815.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$626.52
|
| Rate for Payer: Blue Shield of California EPN |
$498.58
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$857.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$317.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$892.96
|
| Rate for Payer: Heritage Provider Network Senior |
$892.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$629.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$989.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$791.40
|
| Rate for Payer: TriValley Medical Group Senior |
$791.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT OF FRAC OF PHAL W/MAN
|
Facility
|
IP
|
$1,319.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$238.74 |
| Max. Negotiated Rate |
$989.25 |
| Rate for Payer: Adventist Health Commercial |
$263.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$849.44
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$892.96
|
| Rate for Payer: Heritage Provider Network Senior |
$892.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.75
|
| Rate for Payer: Multiplan Commercial |
$989.25
|
|
|
HC CL TREAT OF HEAD/NECK W/MANIPU
|
Facility
|
IP
|
$1,274.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$230.59 |
| Max. Negotiated Rate |
$955.50 |
| Rate for Payer: Adventist Health Commercial |
$254.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$820.46
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$862.50
|
| Rate for Payer: Heritage Provider Network Senior |
$862.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$230.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.50
|
| Rate for Payer: Multiplan Commercial |
$955.50
|
|
|
HC CL TREAT OF HEAD/NECK W/MANIPU
|
Facility
|
OP
|
$1,274.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$230.59 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$254.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$787.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$605.15
|
| Rate for Payer: Blue Shield of California EPN |
$481.57
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$828.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$862.50
|
| Rate for Payer: Heritage Provider Network Senior |
$862.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$230.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$955.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$764.40
|
| Rate for Payer: TriValley Medical Group Senior |
$764.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF HUM SHAFT FRAC
|
Facility
|
IP
|
$1,148.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.79 |
| Max. Negotiated Rate |
$861.00 |
| Rate for Payer: Adventist Health Commercial |
$229.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$739.31
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$777.20
|
| Rate for Payer: Heritage Provider Network Senior |
$777.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.00
|
| Rate for Payer: Multiplan Commercial |
$861.00
|
|
|
HC CL TREAT OF HUM SHAFT FRAC
|
Facility
|
OP
|
$1,148.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$229.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$709.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$545.30
|
| Rate for Payer: Blue Shield of California EPN |
$433.94
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$746.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$777.20
|
| Rate for Payer: Heritage Provider Network Senior |
$777.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$547.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$861.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$688.80
|
| Rate for Payer: TriValley Medical Group Senior |
$688.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF INTPHAL JOINT SIN
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$694.88
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT OF INTPHAL JOINT SIN
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$666.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$512.52
|
| Rate for Payer: Blue Shield of California EPN |
$407.86
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$317.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$514.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$647.40
|
| Rate for Payer: TriValley Medical Group Senior |
$647.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT OF INTRPHAL JONT DISL
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
900501258
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$694.88
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT OF INTRPHAL JONT DISL
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
900501258
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$666.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$512.52
|
| Rate for Payer: Blue Shield of California EPN |
$407.86
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cash Price |
$485.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$317.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$514.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$647.40
|
| Rate for Payer: TriValley Medical Group Senior |
$647.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT OF KNEE DISC W/ANESTH
|
Facility
|
IP
|
$6,134.00
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
900501087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,110.25 |
| Max. Negotiated Rate |
$4,600.50 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,950.30
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,152.72
|
| Rate for Payer: Heritage Provider Network Senior |
$4,152.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,110.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.50
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
|
|
HC CL TREAT OF KNEE DISC W/ANESTH
|
Facility
|
OP
|
$6,134.00
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
900501087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,110.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,790.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,913.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,318.65
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,987.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,152.72
|
| Rate for Payer: Heritage Provider Network Senior |
$4,152.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,925.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,110.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,680.40
|
| Rate for Payer: TriValley Medical Group Senior |
$3,680.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT OF META FRAC SIN W/O
|
Facility
|
OP
|
$3,990.00
|
|
|
Service Code
|
CPT 26500
|
| Hospital Charge Code |
900501075
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.19 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,465.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,435.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,895.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,508.22
|
| Rate for Payer: Cash Price |
$1,795.50
|
| Rate for Payer: Cash Price |
$1,795.50
|
| Rate for Payer: Cash Price |
$1,795.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,332.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,903.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$722.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,732.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,394.00
|
| Rate for Payer: TriValley Medical Group Senior |
$2,394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
