|
HC EGFR
|
Facility
|
OP
|
$491.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
903800314
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$486.87 |
| Rate for Payer: Adventist Health Commercial |
$98.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$262.44
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$337.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$486.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$357.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.23
|
| Rate for Payer: Cash Price |
$270.05
|
| Rate for Payer: Cash Price |
$270.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$319.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$486.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$357.04
|
| Rate for Payer: Dignity Health Senior |
$324.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$319.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$324.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$303.93
|
| Rate for Payer: Heritage Provider Network Senior |
$303.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$291.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$324.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$234.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.97
|
| Rate for Payer: Multiplan Commercial |
$368.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$324.58
|
| Rate for Payer: TriValley Medical Group Senior |
$324.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$350.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$350.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$486.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$357.04
|
| Rate for Payer: Vantage Medical Group Senior |
$324.58
|
|
|
HC EGFR
|
Facility
|
IP
|
$491.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
903800314
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.87 |
| Max. Negotiated Rate |
$368.25 |
| Rate for Payer: Adventist Health Commercial |
$98.20
|
| Rate for Payer: Cash Price |
$270.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$332.41
|
| Rate for Payer: Heritage Provider Network Senior |
$332.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.75
|
| Rate for Payer: Multiplan Commercial |
$368.25
|
|
|
HC EKOS THROMLYSIS CATH
|
Facility
|
OP
|
$6,704.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.80 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$1,340.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,217.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,605.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,698.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,687.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,028.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,695.01
|
| Rate for Payer: Blue Shield of California EPN |
$2,695.01
|
| Rate for Payer: Cash Price |
$3,687.20
|
| Rate for Payer: Cash Price |
$3,687.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,083.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,698.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,698.40
|
| Rate for Payer: Dignity Health Senior |
$5,698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,290.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,103.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3,103.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,352.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,676.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,692.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,692.80
|
| Rate for Payer: Multiplan Commercial |
$5,028.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,422.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,219.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,698.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,698.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5,698.40
|
|
|
HC EKOS THROMLYSIS CATH
|
Facility
|
IP
|
$6,704.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.80 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$1,340.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,217.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,695.01
|
| Rate for Payer: Blue Shield of California EPN |
$2,695.01
|
| Rate for Payer: Cash Price |
$3,687.20
|
| Rate for Payer: Cash Price |
$3,687.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,083.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,620.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,103.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3,103.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,352.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,352.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,676.00
|
| Rate for Payer: Multiplan Commercial |
$5,028.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,422.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,219.69
|
|
|
HC ELASTOPLAST
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7.32
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Senior |
$10.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.43
|
| Rate for Payer: Heritage Provider Network Senior |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
HC ELASTOPLAST
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.12
|
| Rate for Payer: Heritage Provider Network Senior |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$382.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$262.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$324.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$210.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$286.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$248.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$324.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.70
|
| Rate for Payer: Dignity Health Senior |
$324.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$258.61
|
| Rate for Payer: Heritage Provider Network Senior |
$258.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$182.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$267.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$267.40
|
| Rate for Payer: Multiplan Commercial |
$286.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$137.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$126.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$324.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.70
|
| Rate for Payer: Vantage Medical Group Senior |
$324.70
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$382.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.14 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$258.61
|
| Rate for Payer: Heritage Provider Network Senior |
$258.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.50
|
| Rate for Payer: Multiplan Commercial |
$286.50
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$382.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$262.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$324.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$210.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$286.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$248.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$324.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.70
|
| Rate for Payer: Dignity Health Senior |
$324.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$236.46
|
| Rate for Payer: Heritage Provider Network Senior |
$236.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$331.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$182.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$267.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$267.40
|
| Rate for Payer: Multiplan Commercial |
$286.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$324.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.70
|
| Rate for Payer: Vantage Medical Group Senior |
$324.70
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$382.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.14 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Cash Price |
$210.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$258.61
|
| Rate for Payer: Heritage Provider Network Senior |
$258.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.50
|
| Rate for Payer: Multiplan Commercial |
$286.50
|
|
|
HC ELBOW COMPLETE
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| 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: 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 ELBOW COMPLETE
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$552.75 |
| 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 |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.99
|
| Rate for Payer: Blue Shield of California Commercial |
$120.91
|
| Rate for Payer: Blue Shield of California EPN |
$97.23
|
| 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 |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$479.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| 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 |
$42.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$351.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
OP
|
$575.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$307.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$395.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.32
|
| Rate for Payer: Blue Shield of California Commercial |
$107.90
|
| Rate for Payer: Blue Shield of California EPN |
$86.77
|
| Rate for Payer: Cash Price |
$316.25
|
| Rate for Payer: Cash Price |
$316.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$373.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$355.93
|
| Rate for Payer: Heritage Provider Network Senior |
$355.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$274.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
IP
|
$575.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$104.08 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Cash Price |
$316.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$389.27
|
| Rate for Payer: Heritage Provider Network Senior |
$389.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.75
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
|
|
HC ELECTROGSTROGRPHY DIAG TRANSCU
|
Facility
|
IP
|
$1,808.00
|
|
|
Service Code
|
CPT 91132
|
| Hospital Charge Code |
906791132
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$327.25 |
| Max. Negotiated Rate |
$1,356.00 |
| Rate for Payer: Adventist Health Commercial |
$361.60
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,224.02
|
| Rate for Payer: Heritage Provider Network Senior |
$1,224.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.00
|
| Rate for Payer: Multiplan Commercial |
$1,356.00
|
|
|
HC ELECTROGSTROGRPHY DIAG TRANSCU
|
Facility
|
OP
|
$1,808.00
|
|
|
Service Code
|
CPT 91132
|
| Hospital Charge Code |
906791132
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$152.34 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$361.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$966.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,242.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,175.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Senior |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,119.15
|
| Rate for Payer: Heritage Provider Network Senior |
$486.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$152.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$862.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$498.53
|
| Rate for Payer: Multiplan Commercial |
$1,356.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
900912165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$122.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$158.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.04
|
| Rate for Payer: Blue Shield of California Commercial |
$56.45
|
| Rate for Payer: Blue Shield of California EPN |
$45.28
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$149.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.71
|
| Rate for Payer: Dignity Health Senior |
$7.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.37
|
| Rate for Payer: Heritage Provider Network Senior |
$142.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$109.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.83
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.01
|
| Rate for Payer: TriValley Medical Group Senior |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Vantage Medical Group Senior |
$7.01
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
900912165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.63 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$155.71
|
| Rate for Payer: Heritage Provider Network Senior |
$155.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.50
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
|
|
HC ELECTRON MICROSCOPY COMPLEX
|
Facility
|
OP
|
$3,833.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
903800039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$303.38 |
| Max. Negotiated Rate |
$2,874.75 |
| Rate for Payer: Adventist Health Commercial |
$766.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,048.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,633.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,556.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,141.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,037.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$303.38
|
| Rate for Payer: Blue Shield of California Commercial |
$1,589.71
|
| Rate for Payer: Blue Shield of California EPN |
$1,278.39
|
| Rate for Payer: Cash Price |
$2,108.15
|
| Rate for Payer: Cash Price |
$2,108.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,491.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,556.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,141.74
|
| Rate for Payer: Dignity Health Senior |
$1,037.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,491.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,037.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,372.63
|
| Rate for Payer: Heritage Provider Network Senior |
$2,372.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$385.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,037.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,828.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$693.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,193.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$958.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,307.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,307.82
|
| Rate for Payer: Multiplan Commercial |
$2,874.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,037.95
|
| Rate for Payer: TriValley Medical Group Senior |
$1,037.95
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$722.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$722.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,556.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,141.74
|
| Rate for Payer: Vantage Medical Group Senior |
$1,037.95
|
|
|
HC ELECTRON MICROSCOPY COMPLEX
|
Facility
|
IP
|
$3,833.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
903800039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$693.77 |
| Max. Negotiated Rate |
$2,874.75 |
| Rate for Payer: Adventist Health Commercial |
$766.60
|
| Rate for Payer: Cash Price |
$2,108.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,594.94
|
| Rate for Payer: Heritage Provider Network Senior |
$2,594.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$693.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$958.25
|
| Rate for Payer: Multiplan Commercial |
$2,874.75
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
IP
|
$5,458.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906820090
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$987.90 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,091.60
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$987.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,364.50
|
| Rate for Payer: Multiplan Commercial |
$4,093.50
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
OP
|
$5,458.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906820090
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,091.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,749.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,542.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Cash Price |
$3,001.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,547.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,696.75
|
| Rate for Payer: Dignity Health Senior |
$1,542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,547.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,378.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,897.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$850.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,542.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,930.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$987.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,364.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,943.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,943.55
|
| Rate for Payer: Multiplan Commercial |
$4,093.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,696.75
|
| Rate for Payer: TriValley Medical Group Senior |
$1,542.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.50
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
OP
|
$4,639.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906813411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Adventist Health Commercial |
$927.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,186.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,542.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,551.45
|
| Rate for Payer: Cash Price |
$2,551.45
|
| Rate for Payer: Cash Price |
$2,551.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,015.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,696.75
|
| Rate for Payer: Dignity Health Senior |
$1,542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,015.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,140.60
|
| Rate for Payer: Heritage Provider Network Senior |
$3,140.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,542.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,212.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$839.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,159.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,943.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,943.55
|
| Rate for Payer: Multiplan Commercial |
$3,479.25
|
| Rate for Payer: Multiplan WC |
$2,457.69
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,669.11
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,535.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,313.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,696.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.50
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
IP
|
$4,639.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906813411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$839.66 |
| Max. Negotiated Rate |
$3,479.25 |
| Rate for Payer: Adventist Health Commercial |
$927.80
|
| Rate for Payer: Cash Price |
$2,551.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,140.60
|
| Rate for Payer: Heritage Provider Network Senior |
$3,140.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$839.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,159.75
|
| Rate for Payer: Multiplan Commercial |
$3,479.25
|
|
|
HC ELECT STIM MANUAL 15 MIN MC
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
901300049
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
