|
HC FETAL LUNG MATURITY (FLM)
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 83663
|
| Hospital Charge Code |
900910962
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$403.50 |
| Rate for Payer: Adventist Health Commercial |
$107.60
|
| Rate for Payer: Cash Price |
$242.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$364.23
|
| Rate for Payer: Heritage Provider Network Senior |
$364.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.50
|
| Rate for Payer: Multiplan Commercial |
$403.50
|
|
|
HC FETAL NON-STRESS TEST
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
902400362
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$606.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Senior |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$255.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$540.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$322.07
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$281.17
|
| Rate for Payer: TriValley Medical Group Senior |
$255.61
|
| 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 |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC FETAL NON-STRESS TEST
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
902400362
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL NON-STRESS TEST ADDL FETUS
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025 59
|
| Hospital Charge Code |
910400087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$71.07 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$606.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$963.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$623.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$963.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$963.90
|
| Rate for Payer: Dignity Health Senior |
$963.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$540.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$793.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$793.80
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$567.00
|
| Rate for Payer: TriValley Medical Group Senior |
$567.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$567.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$567.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$963.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$963.90
|
| Rate for Payer: Vantage Medical Group Senior |
$963.90
|
|
|
HC FETAL NON-STRESS TEST ADDL FETUS
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025 59
|
| Hospital Charge Code |
910400087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL NON-STRESS TEST SINGLE FETUS
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
910400086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$606.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Senior |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$255.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$540.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$293.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$322.07
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$567.00
|
| Rate for Payer: TriValley Medical Group Senior |
$567.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$567.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$567.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC FETAL NON-STRESS TEST SINGLE FETUS
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
910400086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL SHUNT PLACMNT ADDL FETUS
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT 59076
|
| Hospital Charge Code |
910400093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$659.25 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
|
|
HC FETAL SHUNT PLACMNT ADDL FETUS
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 59076
|
| Hospital Charge Code |
910400093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$603.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$536.19
|
| Rate for Payer: Blue Shield of California EPN |
$428.95
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Senior |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$386.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.10
|
| Rate for Payer: Heritage Provider Network Senior |
$544.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$715.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$419.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$444.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.99
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$439.50
|
| Rate for Payer: TriValley Medical Group Senior |
$439.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$439.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$439.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC FFP PED PAK ALIQUOT
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904530
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$125.80 |
| Max. Negotiated Rate |
$626.00 |
| Rate for Payer: Adventist Health Commercial |
$139.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$371.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$477.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$394.34
|
| Rate for Payer: Blue Shield of California Commercial |
$423.95
|
| Rate for Payer: Blue Shield of California EPN |
$339.16
|
| Rate for Payer: Cash Price |
$312.75
|
| Rate for Payer: Cash Price |
$312.75
|
| Rate for Payer: Cash Price |
$312.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$451.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$270.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.19
|
| Rate for Payer: Dignity Health Senior |
$180.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$180.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$430.20
|
| Rate for Payer: Heritage Provider Network Senior |
$430.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$241.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$180.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$331.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$207.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.01
|
| Rate for Payer: Multiplan Commercial |
$521.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$198.19
|
| Rate for Payer: TriValley Medical Group Senior |
$180.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$626.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$526.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Vantage Medical Group Senior |
$180.17
|
|
|
HC FFP PED PAK ALIQUOT
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904530
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$125.80 |
| Max. Negotiated Rate |
$521.25 |
| Rate for Payer: Adventist Health Commercial |
$139.00
|
| Rate for Payer: Cash Price |
$312.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$470.51
|
| Rate for Payer: Heritage Provider Network Senior |
$470.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.75
|
| Rate for Payer: Multiplan Commercial |
$521.25
|
|
|
HC FFP SPLIT UNIT GT 150 ML
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904533
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$248.25 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$224.09
|
| Rate for Payer: Heritage Provider Network Senior |
$224.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.75
|
| Rate for Payer: Multiplan Commercial |
$248.25
|
|
|
HC FFP SPLIT UNIT GT 150 ML
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904533
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$626.00 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$176.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$227.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$187.81
|
| Rate for Payer: Blue Shield of California Commercial |
$201.91
|
| Rate for Payer: Blue Shield of California EPN |
$161.53
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$215.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$270.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.19
|
| Rate for Payer: Dignity Health Senior |
$180.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$180.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$204.89
|
| Rate for Payer: Heritage Provider Network Senior |
$204.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$241.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$180.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$157.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$207.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.01
|
| Rate for Payer: Multiplan Commercial |
$248.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$198.19
|
| Rate for Payer: TriValley Medical Group Senior |
$180.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$626.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$526.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Vantage Medical Group Senior |
$180.17
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$177.37
|
| Rate for Payer: Heritage Provider Network Senior |
$177.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.82
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Senior |
$6.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.90
|
| Rate for Payer: Heritage Provider Network Senior |
$22.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC FIBRINOGEN ASSAY
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
900910013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$77.07 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$44.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.07
|
| Rate for Payer: Blue Shield of California Commercial |
$68.37
|
| Rate for Payer: Blue Shield of California EPN |
$54.84
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.69
|
| Rate for Payer: Dignity Health Senior |
$9.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.25
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.72
|
| Rate for Payer: TriValley Medical Group Senior |
$9.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Vantage Medical Group Senior |
$9.72
|
|
|
HC FIBRINOGEN ASSAY
|
Facility
|
IP
|
$299.00
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
900910013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.12 |
| Max. Negotiated Rate |
$224.25 |
| Rate for Payer: Adventist Health Commercial |
$59.80
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.42
|
| Rate for Payer: Heritage Provider Network Senior |
$202.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.75
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
|
|
HC FINE NDLE ASPIR W/GUIDANCE
|
Facility
|
OP
|
$3,437.00
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
909000240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$687.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,361.22
|
| 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 |
$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 |
$1,546.65
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,234.05
|
| 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 |
$2,062.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$893.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,127.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,099.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$188.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,698.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,028.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.25
|
| 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 |
$2,577.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$983.38
|
| Rate for Payer: TriValley Medical Group Senior |
$983.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| 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 FINE NDLE ASPIR W/GUIDANCE
|
Facility
|
IP
|
$3,437.00
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
909000240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$622.10 |
| Max. Negotiated Rate |
$2,577.75 |
| Rate for Payer: Adventist Health Commercial |
$687.40
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,326.85
|
| Rate for Payer: Heritage Provider Network Senior |
$2,326.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.25
|
| Rate for Payer: Multiplan Commercial |
$2,577.75
|
|
|
HC FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$246.00 |
| Rate for Payer: Adventist Health Commercial |
$65.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$175.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$225.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.82
|
| Rate for Payer: Blue Shield of California Commercial |
$235.20
|
| Rate for Payer: Blue Shield of California EPN |
$189.14
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$213.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.68
|
| Rate for Payer: Dignity Health Senior |
$67.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.03
|
| Rate for Payer: Heritage Provider Network Senior |
$203.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$156.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85.54
|
| Rate for Payer: Multiplan Commercial |
$246.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.89
|
| Rate for Payer: TriValley Medical Group Senior |
$67.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Vantage Medical Group Senior |
$67.89
|
|
|
HC FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$755.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$136.66 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Adventist Health Commercial |
$151.00
|
| Rate for Payer: Cash Price |
$339.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$511.13
|
| Rate for Payer: Heritage Provider Network Senior |
$511.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.75
|
| Rate for Payer: Multiplan Commercial |
$566.25
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| 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 |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Senior |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.37
|
| Rate for Payer: Heritage Provider Network Senior |
$181.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$139.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$205.10
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$146.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$146.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
IP
|
$1,525.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$276.02 |
| Max. Negotiated Rate |
$1,143.75 |
| Rate for Payer: Adventist Health Commercial |
$305.00
|
| Rate for Payer: Cash Price |
$686.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,032.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,032.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$381.25
|
| Rate for Payer: Multiplan Commercial |
$1,143.75
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$63.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$219.15
|
| 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 |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$194.59
|
| Rate for Payer: Blue Shield of California EPN |
$155.67
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$207.35
|
| 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 |
$197.46
|
| Rate for Payer: Heritage Provider Network Senior |
$197.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$118.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$152.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.75
|
| 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 |
$239.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$507.64
|
| Rate for Payer: TriValley Medical Group Senior |
$507.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$159.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$159.50
|
| 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 FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$63.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$219.15
|
| 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 |
$3,531.00
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$207.35
|
| 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 |
$215.96
|
| Rate for Payer: Heritage Provider Network Senior |
$215.96
|
| 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 |
$152.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.75
|
| 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 |
$239.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$114.78
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$105.62
|
| 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
|
|
