|
HC EVASC ST RPR THRC/AA NO CRSG BR
|
Facility
|
OP
|
$4,762.00
|
|
|
Service Code
|
CPT 33895
|
| Hospital Charge Code |
906820289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$861.92 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$952.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,271.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,047.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,619.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,571.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$2,619.10
|
| Rate for Payer: Cash Price |
$2,619.10
|
| Rate for Payer: Cash Price |
$2,619.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,095.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,047.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,047.70
|
| Rate for Payer: Dignity Health Senior |
$4,047.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,947.68
|
| Rate for Payer: Heritage Provider Network Senior |
$2,947.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,040.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,271.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$861.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,190.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,333.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,333.40
|
| Rate for Payer: Multiplan Commercial |
$3,571.50
|
| 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 |
$4,047.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,047.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,047.70
|
|
|
HC EVASC ST RPR THRC/AA NO CRSG BR
|
Facility
|
IP
|
$4,762.00
|
|
|
Service Code
|
CPT 33895
|
| Hospital Charge Code |
906820289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$861.92 |
| Max. Negotiated Rate |
$3,571.50 |
| Rate for Payer: Adventist Health Commercial |
$952.40
|
| Rate for Payer: Cash Price |
$2,619.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,223.87
|
| Rate for Payer: Heritage Provider Network Senior |
$3,223.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$861.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,190.50
|
| Rate for Payer: Multiplan Commercial |
$3,571.50
|
|
|
HC EV FEM POP ARTERIAL REVASC
|
Facility
|
IP
|
$22,123.00
|
|
|
Service Code
|
CPT 0505T
|
| Hospital Charge Code |
909000505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,004.26 |
| Max. Negotiated Rate |
$16,592.25 |
| Rate for Payer: Adventist Health Commercial |
$4,424.60
|
| Rate for Payer: Cash Price |
$12,167.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,977.27
|
| Rate for Payer: Heritage Provider Network Senior |
$14,977.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,004.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.75
|
| Rate for Payer: Multiplan Commercial |
$16,592.25
|
|
|
HC EV FEM POP ARTERIAL REVASC
|
Facility
|
OP
|
$22,123.00
|
|
|
Service Code
|
CPT 0505T
|
| Hospital Charge Code |
909000505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$4,424.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,198.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| 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 |
$12,167.65
|
| Rate for Payer: Cash Price |
$12,167.65
|
| Rate for Payer: Cash Price |
$12,167.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,379.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,694.14
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,004.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,530.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$16,592.25
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC EV VEN ATLIZTN TBL OR PRL VEIN
|
Facility
|
OP
|
$35,868.00
|
|
|
Service Code
|
CPT 0620T
|
| Hospital Charge Code |
909000620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$84,496.12 |
| Rate for Payer: Adventist Health Commercial |
$7,173.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24,641.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,707.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48,918.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44,471.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$19,727.40
|
| Rate for Payer: Cash Price |
$19,727.40
|
| Rate for Payer: Cash Price |
$19,727.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23,314.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,707.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,918.80
|
| Rate for Payer: Dignity Health Senior |
$44,471.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$44,471.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,202.29
|
| Rate for Payer: Heritage Provider Network Senior |
$54,700.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,471.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$84,496.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,492.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,142.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,967.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,034.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,034.27
|
| Rate for Payer: Multiplan Commercial |
$26,901.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$48,918.80
|
| Rate for Payer: TriValley Medical Group Senior |
$48,918.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$66,707.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,918.80
|
| Rate for Payer: Vantage Medical Group Senior |
$44,471.64
|
|
|
HC EV VEN ATLIZTN TBL OR PRL VEIN
|
Facility
|
IP
|
$35,868.00
|
|
|
Service Code
|
CPT 0620T
|
| Hospital Charge Code |
909000620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,492.11 |
| Max. Negotiated Rate |
$26,901.00 |
| Rate for Payer: Adventist Health Commercial |
$7,173.60
|
| Rate for Payer: Cash Price |
$19,727.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,282.64
|
| Rate for Payer: Heritage Provider Network Senior |
$24,282.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,492.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,967.00
|
| Rate for Payer: Multiplan Commercial |
$26,901.00
|
|
|
HC EWHO COMB HUMERAL RADIUS ULNAR WRIS
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT L3763
|
| Hospital Charge Code |
903203986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$162.36
|
| Rate for Payer: Aetna of CA Gatekeeper |
$190.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$272.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$336.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$297.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$159.19
|
| Rate for Payer: Blue Shield of California EPN |
$159.19
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$182.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$336.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.60
|
| Rate for Payer: Dignity Health Senior |
$336.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.35
|
| Rate for Payer: Heritage Provider Network Senior |
$183.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,188.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$277.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$277.20
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$143.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$336.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.60
|
| Rate for Payer: Vantage Medical Group Senior |
$336.60
|
|
|
HC EWHO COMB HUMERAL RADIUS ULNAR WRIS
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT L3763
|
| Hospital Charge Code |
903203986
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$190.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$159.19
|
| Rate for Payer: Blue Shield of California EPN |
$159.19
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$182.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.35
|
| Rate for Payer: Heritage Provider Network Senior |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.00
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$143.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.12
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
IP
|
$1,620.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$293.22 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,096.74
|
| Rate for Payer: Heritage Provider Network Senior |
$1,096.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
OP
|
$1,620.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,112.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,053.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Senior |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$893.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,096.74
|
| Rate for Payer: Heritage Provider Network Senior |
$1,096.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$772.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,028.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,126.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,126.41
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$582.88
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$536.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
IP
|
$2,061.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$373.04 |
| Max. Negotiated Rate |
$1,545.75 |
| Rate for Payer: Adventist Health Commercial |
$412.20
|
| Rate for Payer: Cash Price |
$1,133.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,395.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,395.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$515.25
|
| Rate for Payer: Multiplan Commercial |
$1,545.75
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
OP
|
$2,061.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$412.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,415.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$1,133.55
|
| Rate for Payer: Cash Price |
$1,133.55
|
| Rate for Payer: Cash Price |
$1,133.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,339.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Senior |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$893.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,395.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,395.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$983.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,028.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$515.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,126.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,126.41
|
| Rate for Payer: Multiplan Commercial |
$1,545.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$741.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$682.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$2,104.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$380.82 |
| Max. Negotiated Rate |
$1,578.00 |
| Rate for Payer: Adventist Health Commercial |
$420.80
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,424.41
|
| Rate for Payer: Heritage Provider Network Senior |
$1,424.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.00
|
| Rate for Payer: Multiplan Commercial |
$1,578.00
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
OP
|
$2,104.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$420.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,445.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,367.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,424.41
|
| Rate for Payer: Heritage Provider Network Senior |
$1,424.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,003.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$1,578.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$757.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$696.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
OP
|
$3,795.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$759.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,607.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,087.25
|
| Rate for Payer: Cash Price |
$2,087.25
|
| Rate for Payer: Cash Price |
$2,087.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,466.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,569.22
|
| Rate for Payer: Heritage Provider Network Senior |
$2,569.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,810.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$948.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$2,846.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,365.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,256.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
IP
|
$3,795.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$686.89 |
| Max. Negotiated Rate |
$2,846.25 |
| Rate for Payer: Adventist Health Commercial |
$759.00
|
| Rate for Payer: Cash Price |
$2,087.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,569.22
|
| Rate for Payer: Heritage Provider Network Senior |
$2,569.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$948.75
|
| Rate for Payer: Multiplan Commercial |
$2,846.25
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
OP
|
$1,362.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$272.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$935.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$749.10
|
| Rate for Payer: Cash Price |
$749.10
|
| Rate for Payer: Cash Price |
$749.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$885.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Senior |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$507.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$922.07
|
| Rate for Payer: Heritage Provider Network Senior |
$922.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$649.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$340.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$639.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$639.63
|
| Rate for Payer: Multiplan Commercial |
$1,021.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$490.05
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$450.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
IP
|
$1,362.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$246.52 |
| Max. Negotiated Rate |
$1,021.50 |
| Rate for Payer: Adventist Health Commercial |
$272.40
|
| Rate for Payer: Cash Price |
$749.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$922.07
|
| Rate for Payer: Heritage Provider Network Senior |
$922.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$340.50
|
| Rate for Payer: Multiplan Commercial |
$1,021.50
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$847.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$678.15
|
| Rate for Payer: Cash Price |
$678.15
|
| Rate for Payer: Cash Price |
$678.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$801.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Senior |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$893.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$834.74
|
| Rate for Payer: Heritage Provider Network Senior |
$834.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$588.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$223.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,028.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,126.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,126.41
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$443.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$408.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$223.17 |
| Max. Negotiated Rate |
$924.75 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Cash Price |
$678.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$834.74
|
| Rate for Payer: Heritage Provider Network Senior |
$834.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$223.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.25
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
OP
|
$1,493.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$298.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,025.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$821.15
|
| Rate for Payer: Cash Price |
$821.15
|
| Rate for Payer: Cash Price |
$821.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$970.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Senior |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$893.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,010.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,010.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$712.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,028.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,126.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,126.41
|
| Rate for Payer: Multiplan Commercial |
$1,119.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$537.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$494.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
IP
|
$1,493.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.23 |
| Max. Negotiated Rate |
$1,119.75 |
| Rate for Payer: Adventist Health Commercial |
$298.60
|
| Rate for Payer: Cash Price |
$821.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,010.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,010.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.25
|
| Rate for Payer: Multiplan Commercial |
$1,119.75
|
|
|
HC EXCHANGE STEERABLE GW
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.10
|
| Rate for Payer: Heritage Provider Network Senior |
$203.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
|
|
HC EXCHANGE STEERABLE GW
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$160.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.00
|
| Rate for Payer: Blue Shield of California Commercial |
$183.00
|
| Rate for Payer: Blue Shield of California EPN |
$146.40
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$195.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.00
|
| Rate for Payer: Dignity Health Senior |
$255.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$195.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$185.70
|
| Rate for Payer: Heritage Provider Network Senior |
$185.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$143.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$210.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.00
|
| Rate for Payer: Vantage Medical Group Senior |
$255.00
|
|
|
HC EXCISION OF GUM LESION
|
Facility
|
OP
|
$3,912.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
900501744
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$782.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,687.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,151.60
|
| Rate for Payer: Cash Price |
$2,151.60
|
| Rate for Payer: Cash Price |
$2,151.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,542.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,648.42
|
| Rate for Payer: Heritage Provider Network Senior |
$2,648.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,866.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$2,934.00
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,407.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,295.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
