|
HC ECHO PLACEMENT TEE PROBE ONLY
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT 93313
|
| Hospital Charge Code |
906813313
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$41.07 |
| Max. Negotiated Rate |
$1,054.17 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$723.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.23
|
| Rate for Payer: Blue Shield of California Commercial |
$51.07
|
| Rate for Payer: Blue Shield of California EPN |
$41.07
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$760.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$690.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$702.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$724.23
|
| Rate for Payer: Heritage Provider Network Senior |
$724.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$558.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$211.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$808.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$773.06
|
| Rate for Payer: TriValley Medical Group Senior |
$702.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC ECHO STRESS TTE COMPLETE
|
Facility
|
OP
|
$1,935.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,451.25 |
| Rate for Payer: Adventist Health Commercial |
$387.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,195.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$967.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.35
|
| Rate for Payer: Blue Shield of California EPN |
$944.28
|
| Rate for Payer: Cash Price |
$870.75
|
| Rate for Payer: Cash Price |
$870.75
|
| Rate for Payer: Cash Price |
$870.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,257.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,141.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$702.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.77
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$923.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$350.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$808.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$1,451.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$773.06
|
| Rate for Payer: TriValley Medical Group Senior |
$702.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC ECHO STRESS TTE COMPLETE
|
Facility
|
IP
|
$1,935.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$350.24 |
| Max. Negotiated Rate |
$1,451.25 |
| Rate for Payer: Adventist Health Commercial |
$387.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,246.14
|
| Rate for Payer: Cash Price |
$870.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,309.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,309.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$350.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.75
|
| Rate for Payer: Multiplan Commercial |
$1,451.25
|
|
|
HC ECHO TEE W/CON 2D INT/RPT
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TEE W/CON 2D INT/RPT
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSESOPHAGEAL (TEE)
|
Facility
|
OP
|
$10,371.00
|
|
|
Service Code
|
CPT 93355
|
| Hospital Charge Code |
900293355
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$8,815.35 |
| Rate for Payer: Adventist Health Commercial |
$2,074.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,409.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,704.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,778.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,187.57
|
| Rate for Payer: Blue Shield of California Commercial |
$6,326.31
|
| Rate for Payer: Blue Shield of California EPN |
$5,061.05
|
| Rate for Payer: Cash Price |
$4,666.95
|
| Rate for Payer: Cash Price |
$4,666.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,741.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,815.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,815.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,118.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,419.65
|
| Rate for Payer: Heritage Provider Network Senior |
$6,419.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,946.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,877.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,259.70
|
| Rate for Payer: Multiplan Commercial |
$7,778.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,815.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,815.35
|
| Rate for Payer: Vantage Medical Group Senior |
$8,815.35
|
|
|
HC ECHO TRANSESOPHAGEAL (TEE)
|
Facility
|
IP
|
$10,371.00
|
|
|
Service Code
|
CPT 93355
|
| Hospital Charge Code |
900293355
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,877.15 |
| Max. Negotiated Rate |
$7,778.25 |
| Rate for Payer: Adventist Health Commercial |
$2,074.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,678.92
|
| Rate for Payer: Cash Price |
$4,666.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,021.17
|
| Rate for Payer: Heritage Provider Network Senior |
$7,021.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,877.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,592.75
|
| Rate for Payer: Multiplan Commercial |
$7,778.25
|
|
|
HC ECHO TRANSTHO W/CON 2D COMPLET
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8923
|
| Hospital Charge Code |
900200242
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TRANSTHO W/CON 2D COMPLET
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8923
|
| Hospital Charge Code |
900200242
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON 2D STRESS
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8928
|
| Hospital Charge Code |
900200247
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON 2D STRESS
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8928
|
| Hospital Charge Code |
900200247
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TRANSTHO W/CON CONGEN F/U
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8922
|
| Hospital Charge Code |
900200241
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CON CONGEN F/U
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8922
|
| Hospital Charge Code |
900200241
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TRANSTHO W/CONT 2D/M-MODE
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8924
|
| Hospital Charge Code |
900200243
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$448.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$516.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$493.58
|
| Rate for Payer: TriValley Medical Group Senior |
$448.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ECHO TRANSTHO W/CONT 2D/M-MODE
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8924
|
| Hospital Charge Code |
900200243
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TRANSTHO W/CONT COMPLETE
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT C8921
|
| Hospital Charge Code |
900200240
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,050.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.00
|
| Rate for Payer: Blue Shield of California EPN |
$829.60
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,052.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,052.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC ECHO TRANSTHO W/CONT COMPLETE
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT C8921
|
| Hospital Charge Code |
900200240
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$307.70 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Adventist Health Commercial |
$340.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,094.80
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,150.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,275.00
|
|
|
HC ECHO TTE W DOPPLER COMPLETE
|
Facility
|
IP
|
$2,713.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
900200248
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$491.05 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Adventist Health Commercial |
$542.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,747.17
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,836.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,836.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$491.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.25
|
| Rate for Payer: Multiplan Commercial |
$2,034.75
|
|
|
HC ECHO TTE W DOPPLER COMPLETE
|
Facility
|
OP
|
$2,713.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
900200248
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Adventist Health Commercial |
$542.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,676.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,357.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,654.93
|
| Rate for Payer: Blue Shield of California EPN |
$1,323.94
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,763.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,600.67
|
| Rate for Payer: EPIC Health Plan Medicare |
$702.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,679.35
|
| Rate for Payer: Heritage Provider Network Senior |
$1,679.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,294.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$491.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$808.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$2,034.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$773.06
|
| Rate for Payer: TriValley Medical Group Senior |
$702.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC ED EVAL & MGMT
|
Facility
|
IP
|
$1,118.00
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
900509281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$202.36 |
| Max. Negotiated Rate |
$838.50 |
| Rate for Payer: Adventist Health Commercial |
$223.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$719.99
|
| Rate for Payer: Cash Price |
$503.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$756.89
|
| Rate for Payer: Heritage Provider Network Senior |
$756.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$202.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.50
|
| Rate for Payer: Multiplan Commercial |
$838.50
|
|
|
HC ED EVAL & MGMT
|
Facility
|
OP
|
$1,118.00
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
900509281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$108.45 |
| Max. Negotiated Rate |
$1,992.00 |
| Rate for Payer: Adventist Health Commercial |
$223.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$690.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$162.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$531.05
|
| Rate for Payer: Blue Shield of California EPN |
$422.60
|
| Rate for Payer: Cash Price |
$503.10
|
| Rate for Payer: Cash Price |
$503.10
|
| Rate for Payer: Cash Price |
$503.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$726.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$162.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$119.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$108.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$756.89
|
| Rate for Payer: Heritage Provider Network Senior |
$756.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$108.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$533.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$202.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$124.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$145.32
|
| Rate for Payer: Multiplan Commercial |
$838.50
|
| Rate for Payer: Multiplan WC |
$178.26
|
| Rate for Payer: TriValley Medical Group Commercial |
$670.80
|
| Rate for Payer: TriValley Medical Group Senior |
$670.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$162.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$119.30
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
