|
HC ECG 48 HR MONITOR-RECORDING
|
Facility
|
OP
|
$1,289.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900200113
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$1,164.00 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$688.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$885.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Blue Shield of California Commercial |
$262.03
|
| Rate for Payer: Blue Shield of California EPN |
$210.72
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$837.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$837.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$797.89
|
| Rate for Payer: Heritage Provider Network Senior |
$797.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$614.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$180.16
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,164.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$979.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ECG 48 HR MONITOR-SCANNING
|
Facility
|
IP
|
$1,913.00
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
900200114
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$346.25 |
| Max. Negotiated Rate |
$1,434.75 |
| Rate for Payer: Adventist Health Commercial |
$382.60
|
| Rate for Payer: Cash Price |
$1,052.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,295.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,295.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$478.25
|
| Rate for Payer: Multiplan Commercial |
$1,434.75
|
|
|
HC ECG 48 HR MONITOR-SCANNING
|
Facility
|
OP
|
$1,913.00
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
900200114
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,434.75 |
| Rate for Payer: Adventist Health Commercial |
$382.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,022.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,314.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$462.58
|
| Rate for Payer: Blue Shield of California EPN |
$371.99
|
| Rate for Payer: Cash Price |
$1,052.15
|
| Rate for Payer: Cash Price |
$1,052.15
|
| Rate for Payer: Cash Price |
$1,052.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,243.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,243.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,184.15
|
| Rate for Payer: Heritage Provider Network Senior |
$1,184.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$912.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$478.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$1,434.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,164.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$979.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG SIGNAL AVERAGE
|
Facility
|
OP
|
$1,080.00
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
900200141
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$43.59 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$216.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$577.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$741.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$248.21
|
| Rate for Payer: Blue Shield of California EPN |
$199.60
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$702.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$668.52
|
| Rate for Payer: Heritage Provider Network Senior |
$668.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$515.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$810.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG SIGNAL AVERAGE
|
Facility
|
IP
|
$1,080.00
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
900200141
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$195.48 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$216.00
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$731.16
|
| Rate for Payer: Heritage Provider Network Senior |
$731.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Multiplan Commercial |
$810.00
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
906593005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$155.84 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$582.90
|
| Rate for Payer: Heritage Provider Network Senior |
$582.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900200101
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$155.84 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$582.90
|
| Rate for Payer: Heritage Provider Network Senior |
$582.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
906593005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$460.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$591.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$559.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$559.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.96
|
| Rate for Payer: Heritage Provider Network Senior |
$532.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$410.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900200101
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$460.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$591.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$559.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$559.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.96
|
| Rate for Payer: Heritage Provider Network Senior |
$532.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$410.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY RSPC CH
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100039
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$183.35 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.80
|
| Rate for Payer: Heritage Provider Network Senior |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
|
|
HC ECG TRACING ONLY RSPC CH
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100039
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$541.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$658.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$627.05
|
| Rate for Payer: Heritage Provider Network Senior |
$627.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$483.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY RSPC EC
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100037
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$541.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$658.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$627.05
|
| Rate for Payer: Heritage Provider Network Senior |
$627.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$483.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY RSPC EC
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100037
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$183.35 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.80
|
| Rate for Payer: Heritage Provider Network Senior |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
|
|
HC ECG TRACING ONLY RSPC HSH
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100040
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$541.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$658.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$627.05
|
| Rate for Payer: Heritage Provider Network Senior |
$627.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$483.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY RSPC HSH
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100040
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$183.35 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.80
|
| Rate for Payer: Heritage Provider Network Senior |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
|
|
HC ECG TRACING ONLY RSPC MC
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100038
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$183.35 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.80
|
| Rate for Payer: Heritage Provider Network Senior |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
|
|
HC ECG TRACING ONLY RSPC MC
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100038
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$541.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Blue Shield of California Commercial |
$93.79
|
| Rate for Payer: Blue Shield of California EPN |
$75.42
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$658.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Senior |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$627.05
|
| Rate for Payer: Heritage Provider Network Senior |
$627.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$483.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.09
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.02
|
| Rate for Payer: TriValley Medical Group Senior |
$75.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$390.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
OP
|
$3,453.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$2,589.75 |
| Rate for Payer: Adventist Health Commercial |
$690.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,845.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,372.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Blue Shield of California Commercial |
$415.82
|
| Rate for Payer: Blue Shield of California EPN |
$334.39
|
| Rate for Payer: Cash Price |
$1,899.15
|
| Rate for Payer: Cash Price |
$1,899.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,244.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Senior |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,244.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$696.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,137.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,137.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$132.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,647.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$624.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$801.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$877.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$877.80
|
| Rate for Payer: Multiplan Commercial |
$2,589.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$696.67
|
| Rate for Payer: TriValley Medical Group Senior |
$696.67
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$353.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$353.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
IP
|
$3,453.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$624.99 |
| Max. Negotiated Rate |
$2,589.75 |
| Rate for Payer: Adventist Health Commercial |
$690.60
|
| Rate for Payer: Cash Price |
$1,899.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,337.68
|
| Rate for Payer: Heritage Provider Network Senior |
$2,337.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$624.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.25
|
| Rate for Payer: Multiplan Commercial |
$2,589.75
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
OP
|
$2,258.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$93.26 |
| Max. Negotiated Rate |
$1,693.50 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,206.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,551.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Blue Shield of California Commercial |
$366.82
|
| Rate for Payer: Blue Shield of California EPN |
$294.98
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,467.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,467.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,397.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,397.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$93.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,077.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$564.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
IP
|
$2,258.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$408.70 |
| Max. Negotiated Rate |
$1,693.50 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,528.67
|
| Rate for Payer: Heritage Provider Network Senior |
$1,528.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$564.50
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$107.69 |
| Max. Negotiated Rate |
$446.25 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Cash Price |
$327.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$321.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$402.81
|
| Rate for Payer: Heritage Provider Network Senior |
$402.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.75
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.88 |
| Max. Negotiated Rate |
$505.75 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$318.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$408.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$327.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$446.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$401.44
|
| Rate for Payer: Blue Shield of California Commercial |
$362.95
|
| Rate for Payer: Blue Shield of California EPN |
$290.36
|
| Rate for Payer: Cash Price |
$327.25
|
| Rate for Payer: Cash Price |
$327.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$386.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$505.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$505.75
|
| Rate for Payer: Dignity Health Senior |
$505.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$368.31
|
| Rate for Payer: Heritage Provider Network Senior |
$368.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$41.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$283.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$416.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$416.50
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$238.00
|
| Rate for Payer: TriValley Medical Group Senior |
$238.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$297.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$297.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$505.75
|
| Rate for Payer: Vantage Medical Group Senior |
$505.75
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$133.40 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$498.95
|
| Rate for Payer: Heritage Provider Network Senior |
$498.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.25
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.88 |
| Max. Negotiated Rate |
$626.45 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$393.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$506.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$626.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$405.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$552.75
|
| Rate for Payer: Blue Shield of California Commercial |
$449.57
|
| Rate for Payer: Blue Shield of California EPN |
$359.66
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: Cash Price |
$405.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$479.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$626.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$626.45
|
| Rate for Payer: Dignity Health Senior |
$626.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$471.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$456.20
|
| Rate for Payer: Heritage Provider Network Senior |
$456.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$41.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$351.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$515.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$515.90
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$294.80
|
| Rate for Payer: TriValley Medical Group Senior |
$294.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$368.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$368.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$626.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$626.45
|
| Rate for Payer: Vantage Medical Group Senior |
$626.45
|
|
