|
HC ECHO-F FETAL 2D F/U
|
Facility
|
OP
|
$1,962.00
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
900200232
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$121.13 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Adventist Health Commercial |
$392.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,048.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,347.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Blue Shield of California Commercial |
$150.62
|
| Rate for Payer: Blue Shield of California EPN |
$121.13
|
| Rate for Payer: Cash Price |
$1,079.10
|
| Rate for Payer: Cash Price |
$1,079.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,275.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Senior |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,275.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$307.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,214.48
|
| Rate for Payer: Heritage Provider Network Senior |
$1,214.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$240.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$935.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$353.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$490.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$386.98
|
| Rate for Payer: Multiplan Commercial |
$1,471.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$307.13
|
| Rate for Payer: TriValley Medical Group Senior |
$307.13
|
| 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 |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC ECHO-F FETAL 2D F/U
|
Facility
|
IP
|
$1,962.00
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
900200232
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$355.12 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Adventist Health Commercial |
$392.40
|
| Rate for Payer: Cash Price |
$1,079.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,328.27
|
| Rate for Payer: Heritage Provider Network Senior |
$1,328.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$490.50
|
| Rate for Payer: Multiplan Commercial |
$1,471.50
|
|
|
HC ECHO-F FETAL DOPPLER F/U
|
Facility
|
IP
|
$1,774.00
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
900200234
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$321.09 |
| Max. Negotiated Rate |
$1,330.50 |
| Rate for Payer: Adventist Health Commercial |
$354.80
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,201.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,201.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$321.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.50
|
| Rate for Payer: Multiplan Commercial |
$1,330.50
|
|
|
HC ECHO-F FETAL DOPPLER F/U
|
Facility
|
OP
|
$1,774.00
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
900200234
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$74.15 |
| Max. Negotiated Rate |
$1,330.50 |
| Rate for Payer: Adventist Health Commercial |
$354.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$948.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,218.74
|
| 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 |
$237.79
|
| Rate for Payer: Blue Shield of California EPN |
$191.22
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,153.10
|
| 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 |
$1,153.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,098.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1,098.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$74.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$846.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.50
|
| 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 |
$1,330.50
|
| 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 PLACEMENT TEE PROBE ONLY
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT 93313
|
| Hospital Charge Code |
906813313
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$41.07 |
| Max. Negotiated Rate |
$1,045.01 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$625.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$803.79
|
| 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 |
$51.07
|
| Rate for Payer: Blue Shield of California EPN |
$41.07
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$760.50
|
| 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 |
$760.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$696.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$724.23
|
| Rate for Payer: Heritage Provider Network Senior |
$724.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$558.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$801.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.50
|
| 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 |
$877.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$766.34
|
| Rate for Payer: TriValley Medical Group Senior |
$696.67
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| 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 PLACEMENT TEE PROBE ONLY
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT 93313
|
| Hospital Charge Code |
906813313
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$211.77 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$792.09
|
| Rate for Payer: Heritage Provider Network Senior |
$792.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
|
|
HC ECHO STRESS TTE COMPLETE
|
Facility
|
IP
|
$1,935.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$350.24 |
| Max. Negotiated Rate |
$1,451.25 |
| Rate for Payer: Adventist Health Commercial |
$387.00
|
| Rate for Payer: Cash Price |
$1,064.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,309.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,309.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.75
|
| Rate for Payer: Multiplan Commercial |
$1,451.25
|
|
|
HC ECHO STRESS TTE COMPLETE
|
Facility
|
OP
|
$1,935.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,451.25 |
| Rate for Payer: Adventist Health Commercial |
$387.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,034.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,329.35
|
| 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 |
$1,180.35
|
| Rate for Payer: Blue Shield of California EPN |
$944.28
|
| Rate for Payer: Cash Price |
$1,064.25
|
| Rate for Payer: Cash Price |
$1,064.25
|
| Rate for Payer: Cash Price |
$1,064.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,257.75
|
| 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 |
$1,257.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$696.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.77
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$400.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$923.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$801.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.75
|
| 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 |
$1,451.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$766.34
|
| Rate for Payer: TriValley Medical Group Senior |
$696.67
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| 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 TEE W/CON 2D INT/RPT
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON 2D INT/RPT
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSESOPHAGEAL (TEE)
|
Facility
|
OP
|
$10,371.00
|
|
|
Service Code
|
CPT 93355
|
| Hospital Charge Code |
900293355
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$8,815.35 |
| Rate for Payer: Adventist Health Commercial |
$2,074.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,543.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,124.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,704.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,778.25
|
| Rate for Payer: Blue Shield of California Commercial |
$6,326.31
|
| Rate for Payer: Blue Shield of California EPN |
$5,061.05
|
| Rate for Payer: Cash Price |
$5,704.05
|
| Rate for Payer: Cash Price |
$5,704.05
|
| Rate for Payer: Cash Price |
$5,704.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,741.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,815.35
|
| Rate for Payer: Dignity Health Senior |
$8,815.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,741.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,419.65
|
| Rate for Payer: Heritage Provider Network Senior |
$6,419.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$313.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,946.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,877.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,259.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,259.70
|
| Rate for Payer: Multiplan Commercial |
$7,778.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,815.35
|
| Rate for Payer: Vantage Medical Group Senior |
$8,815.35
|
|
|
HC ECHO TRANSESOPHAGEAL (TEE)
|
Facility
|
IP
|
$10,371.00
|
|
|
Service Code
|
CPT 93355
|
| Hospital Charge Code |
900293355
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,877.15 |
| Max. Negotiated Rate |
$7,778.25 |
| Rate for Payer: Adventist Health Commercial |
$2,074.20
|
| Rate for Payer: Cash Price |
$5,704.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,021.17
|
| Rate for Payer: Heritage Provider Network Senior |
$7,021.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,877.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.75
|
| Rate for Payer: Multiplan Commercial |
$7,778.25
|
|
|
HC ECHO TRANSTHO W/CON 2D COMPLET
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8923
|
| Hospital Charge Code |
900200242
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON 2D COMPLET
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8923
|
| Hospital Charge Code |
900200242
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TRANSTHO W/CON 2D STRESS
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8928
|
| Hospital Charge Code |
900200247
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TRANSTHO W/CON 2D STRESS
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8928
|
| Hospital Charge Code |
900200247
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON CONGEN F/U
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8922
|
| Hospital Charge Code |
900200241
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON CONGEN F/U
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8922
|
| Hospital Charge Code |
900200241
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TRANSTHO W/CONT 2D/M-MODE
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8924
|
| Hospital Charge Code |
900200243
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Senior |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$453.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$521.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$571.75
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$499.15
|
| Rate for Payer: TriValley Medical Group Senior |
$453.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC ECHO TRANSTHO W/CONT 2D/M-MODE
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8924
|
| Hospital Charge Code |
900200243
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CONT COMPLETE
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8921
|
| Hospital Charge Code |
900200240
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,505.78 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$908.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Senior |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,105.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,003.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,264.85
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,104.23
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
