|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
IP
|
$1,487.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$269.15 |
| Max. Negotiated Rate |
$1,115.25 |
| Rate for Payer: Adventist Health Commercial |
$297.40
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,006.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,006.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$269.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.75
|
| Rate for Payer: Multiplan Commercial |
$1,115.25
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
OP
|
$1,487.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$297.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,021.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,263.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$817.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,115.25
|
| 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 |
$817.85
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$966.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,263.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,263.95
|
| Rate for Payer: Dignity Health Senior |
$1,263.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$920.45
|
| Rate for Payer: Heritage Provider Network Senior |
$920.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,982.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$709.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$269.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,040.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,040.90
|
| Rate for Payer: Multiplan Commercial |
$1,115.25
|
| 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 |
$1,263.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,263.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,263.95
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$402.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$80.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$276.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$261.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Senior |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$255.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$272.15
|
| Rate for Payer: Heritage Provider Network Senior |
$272.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$191.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$322.07
|
| Rate for Payer: Multiplan Commercial |
$301.50
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$144.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$133.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$402.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.76 |
| Max. Negotiated Rate |
$301.50 |
| Rate for Payer: Adventist Health Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$272.15
|
| Rate for Payer: Heritage Provider Network Senior |
$272.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.50
|
| Rate for Payer: Multiplan Commercial |
$301.50
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$4,737.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$857.40 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$947.40
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Cash Price |
$2,605.35
|
| 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 |
$857.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,184.25
|
| Rate for Payer: Multiplan Commercial |
$3,552.75
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$5,573.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,114.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,828.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$3,065.15
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,622.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,449.69
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$385.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,008.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$4,179.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,810.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,810.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$4,737.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$947.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,254.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$2,605.35
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,079.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,932.20
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$385.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$857.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,184.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,552.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,810.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,810.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$5,573.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,008.71 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,114.60
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Cash Price |
$3,065.15
|
| 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 |
$1,008.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.25
|
| Rate for Payer: Multiplan Commercial |
$4,179.75
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
IP
|
$6,274.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,135.59 |
| Max. Negotiated Rate |
$4,705.50 |
| Rate for Payer: Adventist Health Commercial |
$1,254.80
|
| Rate for Payer: Cash Price |
$3,450.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,247.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,247.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,135.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,568.50
|
| Rate for Payer: Multiplan Commercial |
$4,705.50
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
OP
|
$6,274.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,254.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,310.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,332.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,450.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,705.50
|
| 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 |
$3,450.70
|
| Rate for Payer: Cash Price |
$3,450.70
|
| Rate for Payer: Cash Price |
$3,450.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,078.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,332.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,332.90
|
| Rate for Payer: Dignity Health Senior |
$5,332.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,883.61
|
| Rate for Payer: Heritage Provider Network Senior |
$3,883.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$151.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,992.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,135.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,568.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,391.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,391.80
|
| Rate for Payer: Multiplan Commercial |
$4,705.50
|
| 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 |
$5,332.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,332.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,332.90
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$452.25 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.23
|
| Rate for Payer: Heritage Provider Network Senior |
$408.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$512.55 |
| Rate for Payer: Adventist Health Commercial |
$247.23
|
| Rate for Payer: Aetna of CA Gatekeeper |
$322.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$331.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$452.25
|
| 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 |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$391.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$512.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$512.55
|
| Rate for Payer: Dignity Health Senior |
$512.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$391.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$373.26
|
| Rate for Payer: Heritage Provider Network Senior |
$373.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$186.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$287.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.10
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$512.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$512.55
|
| Rate for Payer: Vantage Medical Group Senior |
$512.55
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$452.25 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.23
|
| Rate for Payer: Heritage Provider Network Senior |
$408.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$512.55 |
| Rate for Payer: Adventist Health Commercial |
$247.23
|
| Rate for Payer: Aetna of CA Gatekeeper |
$322.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$331.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$452.25
|
| 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 |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$391.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$512.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$512.55
|
| Rate for Payer: Dignity Health Senior |
$512.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$391.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$373.26
|
| Rate for Payer: Heritage Provider Network Senior |
$373.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$186.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$287.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.10
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$512.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$512.55
|
| Rate for Payer: Vantage Medical Group Senior |
$512.55
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$1,978.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,358.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$1,087.90
|
| Rate for Payer: Cash Price |
$1,087.90
|
| Rate for Payer: Cash Price |
$1,087.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,285.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,224.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$202.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$943.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$1,978.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$1,483.50 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Cash Price |
$1,087.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,339.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1,339.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.50
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$4,026.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$728.71 |
| Max. Negotiated Rate |
$3,019.50 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Cash Price |
$2,214.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,725.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,725.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$728.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$4,026.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,765.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$2,214.30
|
| Rate for Payer: Cash Price |
$2,214.30
|
| Rate for Payer: Cash Price |
$2,214.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,616.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.09
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$380.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,920.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$728.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$289.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$246.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$6,511.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,302.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,473.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$3,581.05
|
| Rate for Payer: Cash Price |
$3,581.05
|
| Rate for Payer: Cash Price |
$3,581.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,232.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,030.31
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$408.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,105.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,178.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$4,883.25
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$6,511.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,178.49 |
| Max. Negotiated Rate |
$4,883.25 |
| Rate for Payer: Adventist Health Commercial |
$1,302.20
|
| Rate for Payer: Cash Price |
$3,581.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,407.95
|
| Rate for Payer: Heritage Provider Network Senior |
$4,407.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,178.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.75
|
| Rate for Payer: Multiplan Commercial |
$4,883.25
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
OP
|
$2,727.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,873.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| 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 |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cash Price |
$1,499.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$432.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
