|
HC EPS ESOPHOGEAL ATRIAL RECORD
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93615
|
| Hospital Charge Code |
906811326
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| 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 |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$5,856.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,059.94 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,171.20
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| 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 |
$1,059.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,464.00
|
| Rate for Payer: Multiplan Commercial |
$4,392.00
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$901.02 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| 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 |
$901.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
|
|
HC EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906811327
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$995.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,660.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,419.89
|
| 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 |
$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 |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cash Price |
$2,737.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,235.70
|
| 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 |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,081.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,897.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$151.44
|
| 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 |
$901.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.50
|
| 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 |
$3,733.50
|
| 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 EPS ESOPHOGEAL ATRIAL REC/PAC
|
Facility
|
OP
|
$5,856.00
|
|
|
Service Code
|
CPT 93616
|
| Hospital Charge Code |
906820046
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,171.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,130.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,023.07
|
| 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 |
$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 |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,806.40
|
| 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 |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,624.86
|
| Rate for Payer: Heritage Provider Network Senior |
$1,897.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$151.44
|
| 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 |
$1,059.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,464.00
|
| 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 |
$4,392.00
|
| 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 EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$10,363.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,875.70 |
| Max. Negotiated Rate |
$7,772.25 |
| Rate for Payer: Adventist Health Commercial |
$2,072.60
|
| Rate for Payer: Cash Price |
$5,699.65
|
| Rate for Payer: Cash Price |
$5,699.65
|
| 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 |
$1,875.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,590.75
|
| Rate for Payer: Multiplan Commercial |
$7,772.25
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$12,192.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,206.75 |
| Max. Negotiated Rate |
$9,144.00 |
| Rate for Payer: Adventist Health Commercial |
$2,438.40
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| 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 |
$2,206.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,048.00
|
| Rate for Payer: Multiplan Commercial |
$9,144.00
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$12,192.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906820037
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$462.70 |
| Max. Negotiated Rate |
$18,318.74 |
| Rate for Payer: Adventist Health Commercial |
$2,438.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,516.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,375.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Cash Price |
$6,705.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,924.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Senior |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,641.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,546.85
|
| Rate for Payer: Heritage Provider Network Senior |
$11,858.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$462.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$18,318.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,206.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,087.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,048.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,148.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,148.21
|
| Rate for Payer: Multiplan Commercial |
$9,144.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| 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 |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
HC EPS FOLLOW-UP STUDY
|
Facility
|
OP
|
$10,363.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$462.70 |
| Max. Negotiated Rate |
$18,318.74 |
| Rate for Payer: Adventist Health Commercial |
$2,072.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,539.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,119.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,641.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$5,699.65
|
| Rate for Payer: Cash Price |
$5,699.65
|
| Rate for Payer: Cash Price |
$5,699.65
|
| Rate for Payer: Cash Price |
$5,699.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,735.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,462.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,605.58
|
| Rate for Payer: Dignity Health Senior |
$9,641.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,641.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,414.70
|
| Rate for Payer: Heritage Provider Network Senior |
$11,858.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$462.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,641.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$18,318.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,875.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,087.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,590.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,148.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,148.21
|
| Rate for Payer: Multiplan Commercial |
$7,772.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,600.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5,600.00
|
| 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 |
$14,462.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,605.58
|
| Rate for Payer: Vantage Medical Group Senior |
$9,641.44
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
IP
|
$15,911.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906820048
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,879.89 |
| Max. Negotiated Rate |
$11,933.25 |
| Rate for Payer: Adventist Health Commercial |
$3,182.20
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| 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 |
$2,879.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,977.75
|
| Rate for Payer: Multiplan Commercial |
$11,933.25
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
IP
|
$13,524.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,447.84 |
| Max. Negotiated Rate |
$10,143.00 |
| Rate for Payer: Adventist Health Commercial |
$2,704.80
|
| Rate for Payer: Cash Price |
$7,438.20
|
| Rate for Payer: Cash Price |
$7,438.20
|
| 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 |
$2,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,381.00
|
| Rate for Payer: Multiplan Commercial |
$10,143.00
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$15,911.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906820048
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$13,524.35 |
| Rate for Payer: Adventist Health Commercial |
$3,182.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,930.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,524.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,751.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,933.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Cash Price |
$8,751.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,342.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,524.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,524.35
|
| Rate for Payer: Dignity Health Senior |
$13,524.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,342.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,848.91
|
| Rate for Payer: Heritage Provider Network Senior |
$9,848.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,132.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,589.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,879.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,977.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,137.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,137.70
|
| Rate for Payer: Multiplan Commercial |
$11,933.25
|
| 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 |
$13,524.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,524.35
|
| Rate for Payer: Vantage Medical Group Senior |
$13,524.35
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$13,524.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$11,495.40 |
| Rate for Payer: Adventist Health Commercial |
$2,704.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,290.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,495.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,438.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,143.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$7,438.20
|
| Rate for Payer: Cash Price |
$7,438.20
|
| Rate for Payer: Cash Price |
$7,438.20
|
| Rate for Payer: Cash Price |
$7,438.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,790.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,495.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,495.40
|
| Rate for Payer: Dignity Health Senior |
$11,495.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,790.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,371.36
|
| Rate for Payer: Heritage Provider Network Senior |
$8,371.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,132.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,450.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,381.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,466.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,466.80
|
| Rate for Payer: Multiplan Commercial |
$10,143.00
|
| 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 |
$11,495.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,495.40
|
| Rate for Payer: Vantage Medical Group Senior |
$11,495.40
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
OP
|
$10,321.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906820049
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$2,064.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,090.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,772.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,676.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,740.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$5,676.55
|
| Rate for Payer: Cash Price |
$5,676.55
|
| Rate for Payer: Cash Price |
$5,676.55
|
| Rate for Payer: Cash Price |
$5,676.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,708.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,772.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,772.85
|
| Rate for Payer: Dignity Health Senior |
$8,772.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,708.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,388.70
|
| Rate for Payer: Heritage Provider Network Senior |
$6,388.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,132.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,923.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,868.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,580.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,224.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,224.70
|
| Rate for Payer: Multiplan Commercial |
$7,740.75
|
| 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 |
$8,772.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,772.85
|
| Rate for Payer: Vantage Medical Group Senior |
$8,772.85
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
OP
|
$8,773.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,754.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,027.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,457.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,825.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,579.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$4,825.15
|
| Rate for Payer: Cash Price |
$4,825.15
|
| Rate for Payer: Cash Price |
$4,825.15
|
| Rate for Payer: Cash Price |
$4,825.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,702.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,457.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,457.05
|
| Rate for Payer: Dignity Health Senior |
$7,457.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,702.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,430.49
|
| Rate for Payer: Heritage Provider Network Senior |
$5,430.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,132.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,184.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,587.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,193.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,141.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,141.10
|
| Rate for Payer: Multiplan Commercial |
$6,579.75
|
| 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 |
$7,457.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,457.05
|
| Rate for Payer: Vantage Medical Group Senior |
$7,457.05
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
IP
|
$10,321.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906820049
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,868.10 |
| Max. Negotiated Rate |
$7,740.75 |
| Rate for Payer: Adventist Health Commercial |
$2,064.20
|
| Rate for Payer: Cash Price |
$5,676.55
|
| Rate for Payer: Cash Price |
$5,676.55
|
| 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 |
$1,868.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,580.25
|
| Rate for Payer: Multiplan Commercial |
$7,740.75
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
IP
|
$8,773.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,587.91 |
| Max. Negotiated Rate |
$6,579.75 |
| Rate for Payer: Adventist Health Commercial |
$1,754.60
|
| Rate for Payer: Cash Price |
$4,825.15
|
| Rate for Payer: Cash Price |
$4,825.15
|
| 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 |
$1,587.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,193.25
|
| Rate for Payer: Multiplan Commercial |
$6,579.75
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
OP
|
$9,136.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906820050
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,827.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,883.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,276.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,765.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,024.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,852.00
|
| 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 |
$5,024.80
|
| Rate for Payer: Cash Price |
$5,024.80
|
| Rate for Payer: Cash Price |
$5,024.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,938.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,765.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,765.60
|
| Rate for Payer: Dignity Health Senior |
$7,765.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,938.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,655.18
|
| Rate for Payer: Heritage Provider Network Senior |
$5,655.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,357.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,653.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,395.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,395.20
|
| Rate for Payer: Multiplan Commercial |
$6,852.00
|
| 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 |
$7,765.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,765.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7,765.60
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
IP
|
$5,506.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$996.59 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,101.20
|
| Rate for Payer: Cash Price |
$3,028.30
|
| Rate for Payer: Cash Price |
$3,028.30
|
| 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 |
$996.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,376.50
|
| Rate for Payer: Multiplan Commercial |
$4,129.50
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
OP
|
$5,506.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,101.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,942.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,782.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,680.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,028.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,129.50
|
| 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 |
$3,028.30
|
| Rate for Payer: Cash Price |
$3,028.30
|
| Rate for Payer: Cash Price |
$3,028.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,578.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,680.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,680.10
|
| Rate for Payer: Dignity Health Senior |
$4,680.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,578.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,408.21
|
| Rate for Payer: Heritage Provider Network Senior |
$3,408.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,626.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$996.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,376.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,854.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,854.20
|
| Rate for Payer: Multiplan Commercial |
$4,129.50
|
| 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 |
$4,680.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,680.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,680.10
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
IP
|
$9,136.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906820050
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,653.62 |
| Max. Negotiated Rate |
$6,852.00 |
| Rate for Payer: Adventist Health Commercial |
$1,827.20
|
| Rate for Payer: Cash Price |
$5,024.80
|
| Rate for Payer: Cash Price |
$5,024.80
|
| 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 |
$1,653.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,284.00
|
| Rate for Payer: Multiplan Commercial |
$6,852.00
|
|
|
HC EPS RV RECORDING
|
Facility
|
IP
|
$7,039.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906820041
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,274.06 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,407.80
|
| Rate for Payer: Cash Price |
$3,871.45
|
| Rate for Payer: Cash Price |
$3,871.45
|
| 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 |
$1,274.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.75
|
| Rate for Payer: Multiplan Commercial |
$5,279.25
|
|
|
HC EPS RV RECORDING
|
Facility
|
IP
|
$5,983.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,082.92 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,196.60
|
| Rate for Payer: Cash Price |
$3,290.65
|
| Rate for Payer: Cash Price |
$3,290.65
|
| 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 |
$1,082.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,495.75
|
| Rate for Payer: Multiplan Commercial |
$4,487.25
|
|
|
HC EPS RV RECORDING
|
Facility
|
OP
|
$5,983.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$258.08 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,196.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,197.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,110.32
|
| 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 |
$3,290.65
|
| Rate for Payer: Cash Price |
$3,290.65
|
| Rate for Payer: Cash Price |
$3,290.65
|
| Rate for Payer: Cash Price |
$3,290.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,888.95
|
| 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 |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,703.48
|
| Rate for Payer: Heritage Provider Network Senior |
$1,897.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$258.08
|
| 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 |
$1,082.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,495.75
|
| 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 |
$4,487.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,200.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,200.00
|
| 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 EPS RV RECORDING
|
Facility
|
OP
|
$7,039.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906820041
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$258.08 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,407.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,762.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,835.79
|
| 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 |
$3,871.45
|
| Rate for Payer: Cash Price |
$3,871.45
|
| Rate for Payer: Cash Price |
$3,871.45
|
| Rate for Payer: Cash Price |
$3,871.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,575.35
|
| 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 |
$8,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,542.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,357.14
|
| Rate for Payer: Heritage Provider Network Senior |
$1,897.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$258.08
|
| 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 |
$1,274.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,773.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.75
|
| 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 |
$5,279.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,200.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,200.00
|
| 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
|
|
