|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$3,514.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$636.03 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$702.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,414.12
|
| Rate for Payer: Cash Price |
$1,581.30
|
| Rate for Payer: Cash Price |
$1,581.30
|
| 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 |
$636.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$878.50
|
| Rate for Payer: Multiplan Commercial |
$2,635.50
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$448.16 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$495.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,701.01
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| 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 |
$448.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.00
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$3,514.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$7,340.00 |
| Rate for Payer: Adventist Health Commercial |
$702.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,414.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,581.30
|
| Rate for Payer: Cash Price |
$1,581.30
|
| Rate for Payer: Cash Price |
$1,581.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: Dignity Health Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,284.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,001.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,175.17
|
| Rate for Payer: Heritage Provider Network Senior |
$2,461.24
|
| Rate for Payer: Humana Medicare |
$2,001.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$198.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,801.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$636.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,361.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$878.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,521.27
|
| Rate for Payer: Multiplan Commercial |
$2,635.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,201.11
|
| Rate for Payer: TriValley Medical Group Senior |
$2,001.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$3,514.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$636.03 |
| Max. Negotiated Rate |
$2,635.50 |
| Rate for Payer: Adventist Health Commercial |
$702.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,414.12
|
| Rate for Payer: Cash Price |
$1,581.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,378.98
|
| Rate for Payer: Heritage Provider Network Senior |
$2,378.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$636.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$878.50
|
| Rate for Payer: Multiplan Commercial |
$2,635.50
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$671.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$121.45 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$134.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$460.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$416.69
|
| Rate for Payer: Blue Shield of California EPN |
$393.88
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$436.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$415.35
|
| Rate for Payer: Heritage Provider Network Senior |
$415.35
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$303.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$503.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.56
|
| Rate for Payer: TriValley Medical Group Senior |
$159.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$671.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$121.45 |
| Max. Negotiated Rate |
$503.25 |
| Rate for Payer: Adventist Health Commercial |
$134.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$460.98
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$454.27
|
| Rate for Payer: Heritage Provider Network Senior |
$454.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.75
|
| Rate for Payer: Multiplan Commercial |
$503.25
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$174.48 |
| Max. Negotiated Rate |
$723.00 |
| Rate for Payer: Adventist Health Commercial |
$192.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$662.27
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$652.63
|
| Rate for Payer: Heritage Provider Network Senior |
$652.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.00
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$671.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$121.45 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$134.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$460.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$436.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$454.27
|
| Rate for Payer: Heritage Provider Network Senior |
$454.27
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$323.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$503.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$243.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$224.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$155.16 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$192.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$662.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$598.64
|
| Rate for Payer: Blue Shield of California EPN |
$565.87
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$626.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$596.72
|
| Rate for Payer: Heritage Provider Network Senior |
$596.72
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$303.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.56
|
| Rate for Payer: TriValley Medical Group Senior |
$159.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$671.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$121.45 |
| Max. Negotiated Rate |
$503.25 |
| Rate for Payer: Adventist Health Commercial |
$134.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$460.98
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$454.27
|
| Rate for Payer: Heritage Provider Network Senior |
$454.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.75
|
| Rate for Payer: Multiplan Commercial |
$503.25
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
IP
|
$13,065.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,364.76 |
| Max. Negotiated Rate |
$9,798.75 |
| Rate for Payer: Adventist Health Commercial |
$2,613.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,975.66
|
| Rate for Payer: Cash Price |
$5,879.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,845.00
|
| Rate for Payer: Heritage Provider Network Senior |
$8,845.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,364.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,266.25
|
| Rate for Payer: Multiplan Commercial |
$9,798.75
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$13,065.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.30 |
| Max. Negotiated Rate |
$9,798.75 |
| Rate for Payer: Adventist Health Commercial |
$2,613.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,975.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$5,879.25
|
| Rate for Payer: Cash Price |
$5,879.25
|
| Rate for Payer: Cash Price |
$5,879.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,492.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: Dignity Health Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,322.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,087.24
|
| Rate for Payer: Heritage Provider Network Senior |
$5,316.82
|
| Rate for Payer: Humana Medicare |
$4,322.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$408.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,212.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,364.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,100.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,266.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,446.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,446.50
|
| Rate for Payer: Multiplan Commercial |
$9,798.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,754.88
|
| Rate for Payer: TriValley Medical Group Senior |
$4,754.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$661.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.64 |
| Max. Negotiated Rate |
$495.75 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$454.11
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$447.50
|
| Rate for Payer: Heritage Provider Network Senior |
$447.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.25
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$661.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$119.64 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$454.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$410.48
|
| Rate for Payer: Blue Shield of California EPN |
$388.01
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$429.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: Dignity Health Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$195.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$409.16
|
| Rate for Payer: Heritage Provider Network Senior |
$409.16
|
| Rate for Payer: Humana Medicare |
$195.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$168.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$370.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.91
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$214.69
|
| Rate for Payer: TriValley Medical Group Senior |
$195.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$661.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.64 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$454.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$429.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: Dignity Health Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$195.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$447.50
|
| Rate for Payer: Heritage Provider Network Senior |
$447.50
|
| Rate for Payer: Humana Medicare |
$195.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$318.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.91
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$240.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$661.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$119.64 |
| Max. Negotiated Rate |
$495.75 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$454.11
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$447.50
|
| Rate for Payer: Heritage Provider Network Senior |
$447.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.25
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,720.25 |
| Max. Negotiated Rate |
$11,271.75 |
| Rate for Payer: Adventist Health Commercial |
$3,005.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,324.92
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,174.63
|
| Rate for Payer: Heritage Provider Network Senior |
$10,174.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,720.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,757.25
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$27,338.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$547.68 |
| Max. Negotiated Rate |
$23,237.30 |
| Rate for Payer: Adventist Health Commercial |
$5,467.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,781.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,237.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,035.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,503.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,231.15
|
| Rate for Payer: Blue Shield of California EPN |
$8,793.20
|
| Rate for Payer: Cash Price |
$12,302.10
|
| Rate for Payer: Cash Price |
$12,302.10
|
| Rate for Payer: Cash Price |
$12,302.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,769.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,237.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,237.30
|
| Rate for Payer: Dignity Health Senior |
$23,237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,922.22
|
| Rate for Payer: Heritage Provider Network Senior |
$16,922.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$547.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,176.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,948.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,834.50
|
| Rate for Payer: Multiplan Commercial |
$20,503.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,237.30
|
| Rate for Payer: Vantage Medical Group Senior |
$23,237.30
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$547.68 |
| Max. Negotiated Rate |
$12,774.65 |
| Rate for Payer: Adventist Health Commercial |
$3,005.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,324.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,265.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,271.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,231.15
|
| Rate for Payer: Blue Shield of California EPN |
$8,793.20
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,768.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,774.65
|
| Rate for Payer: Dignity Health Senior |
$12,774.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,302.95
|
| Rate for Payer: Heritage Provider Network Senior |
$9,302.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$547.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,243.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,720.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,757.25
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,774.65
|
| Rate for Payer: Vantage Medical Group Senior |
$12,774.65
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$27,338.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,948.18 |
| Max. Negotiated Rate |
$20,503.50 |
| Rate for Payer: Adventist Health Commercial |
$5,467.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,781.21
|
| Rate for Payer: Cash Price |
$12,302.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,507.83
|
| Rate for Payer: Heritage Provider Network Senior |
$18,507.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,948.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,834.50
|
| Rate for Payer: Multiplan Commercial |
$20,503.50
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$15,090.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.46 |
| Max. Negotiated Rate |
$13,479.00 |
| Rate for Payer: Adventist Health Commercial |
$3,018.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,366.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,808.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: Dignity Health Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,866.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,340.71
|
| Rate for Payer: Heritage Provider Network Senior |
$8,445.27
|
| Rate for Payer: Humana Medicare |
$6,866.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$197.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,045.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,731.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,101.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,772.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,651.25
|
| Rate for Payer: Multiplan Commercial |
$11,317.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,552.68
|
| Rate for Payer: TriValley Medical Group Senior |
$7,552.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$15,090.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,731.29 |
| Max. Negotiated Rate |
$11,317.50 |
| Rate for Payer: Adventist Health Commercial |
$3,018.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,366.83
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,215.93
|
| Rate for Payer: Heritage Provider Network Senior |
$10,215.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,731.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,772.50
|
| Rate for Payer: Multiplan Commercial |
$11,317.50
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
IP
|
$12,521.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,266.30 |
| Max. Negotiated Rate |
$9,390.75 |
| Rate for Payer: Adventist Health Commercial |
$2,504.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,601.93
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,476.72
|
| Rate for Payer: Heritage Provider Network Senior |
$8,476.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,266.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,130.25
|
| Rate for Payer: Multiplan Commercial |
$9,390.75
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
OP
|
$12,521.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.60 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,504.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,601.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,562.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,499.32
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,138.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,750.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$405.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,266.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,130.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$9,390.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4,380.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
OP
|
$12,521.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,504.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,601.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cash Price |
$5,634.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,138.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,476.72
|
| Rate for Payer: Heritage Provider Network Senior |
$8,476.72
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,035.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,266.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,130.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$9,390.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,546.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4,183.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
