|
HC GASTRODUODENOSTOMY
|
Facility
|
OP
|
$10,218.00
|
|
|
Service Code
|
CPT 43810
|
| Hospital Charge Code |
906743810
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$178.52 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,043.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,461.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,019.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,685.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,619.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,663.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,619.90
|
| Rate for Payer: Cash Price |
$5,619.90
|
| Rate for Payer: Cash Price |
$5,619.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,641.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,685.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,685.30
|
| Rate for Payer: Dignity Health Senior |
$8,685.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,324.94
|
| Rate for Payer: Heritage Provider Network Senior |
$6,324.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$178.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,873.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,849.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,554.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,152.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,152.60
|
| Rate for Payer: Multiplan Commercial |
$7,663.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| 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 |
$8,685.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,685.30
|
| Rate for Payer: Vantage Medical Group Senior |
$8,685.30
|
|
|
HC GASTROESOPHAGEAL REFLUX
|
Facility
|
IP
|
$1,552.00
|
|
|
Service Code
|
CPT 78262
|
| Hospital Charge Code |
909301365
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$280.91 |
| Max. Negotiated Rate |
$1,164.00 |
| Rate for Payer: Adventist Health Commercial |
$310.40
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,050.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,050.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.00
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
|
|
HC GASTROESOPHAGEAL REFLUX
|
Facility
|
OP
|
$1,552.00
|
|
|
Service Code
|
CPT 78262
|
| Hospital Charge Code |
909301365
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$175.19 |
| Max. Negotiated Rate |
$1,164.00 |
| Rate for Payer: Adventist Health Commercial |
$310.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$829.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,066.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Blue Shield of California Commercial |
$894.29
|
| Rate for Payer: Blue Shield of California EPN |
$719.16
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,008.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Senior |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,008.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$510.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$960.69
|
| Rate for Payer: Heritage Provider Network Senior |
$960.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$175.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$740.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.32
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$561.63
|
| Rate for Payer: TriValley Medical Group Senior |
$510.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$776.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$776.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
IP
|
$2,087.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791034
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$377.75 |
| Max. Negotiated Rate |
$1,565.25 |
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,412.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,412.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.75
|
| Rate for Payer: Multiplan Commercial |
$1,565.25
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
OP
|
$2,087.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791034
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,115.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,433.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| 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 |
$1,147.85
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Cash Price |
$1,147.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,356.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Senior |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$674.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,291.85
|
| Rate for Payer: Heritage Provider Network Senior |
$829.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$125.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$995.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$775.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$849.47
|
| Rate for Payer: Multiplan Commercial |
$1,565.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT 91035
|
| Hospital Charge Code |
906791035
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$165.94 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$516.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$663.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| 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 |
$531.30
|
| Rate for Payer: Cash Price |
$531.30
|
| Rate for Payer: Cash Price |
$531.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$627.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Senior |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$674.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$597.95
|
| Rate for Payer: Heritage Provider Network Senior |
$829.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$165.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$460.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$775.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$849.47
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 91035
|
| Hospital Charge Code |
906791035
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Cash Price |
$531.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.98
|
| Rate for Payer: Heritage Provider Network Senior |
$653.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
|
|
HC GASTROJEJUNOSTOMY SET D/L
|
Facility
|
OP
|
$928.00
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
909001042
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$232.00 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$380.48
|
| Rate for Payer: Aetna of CA Gatekeeper |
$445.44
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$637.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$788.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$510.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$373.06
|
| Rate for Payer: Blue Shield of California EPN |
$373.06
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$426.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$788.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$788.80
|
| Rate for Payer: Dignity Health Senior |
$788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.66
|
| Rate for Payer: Heritage Provider Network Senior |
$429.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$464.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$464.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$464.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$649.60
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$335.29
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$307.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$788.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$788.80
|
| Rate for Payer: Vantage Medical Group Senior |
$788.80
|
|
|
HC GASTROJEJUNOSTOMY SET D/L
|
Facility
|
IP
|
$928.00
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
909001042
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$185.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$185.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$445.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$373.06
|
| Rate for Payer: Blue Shield of California EPN |
$373.06
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$426.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$501.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.66
|
| Rate for Payer: Heritage Provider Network Senior |
$429.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$464.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$464.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$464.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.00
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$335.29
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$307.26
|
|
|
HC GASTROJEJUNOSTOMY SET SGL/LMN
|
Facility
|
OP
|
$619.00
|
|
| Hospital Charge Code |
909001041
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$154.75 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$253.79
|
| Rate for Payer: Aetna of CA Gatekeeper |
$297.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$425.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$526.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$340.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$464.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$248.84
|
| Rate for Payer: Blue Shield of California EPN |
$248.84
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$284.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$526.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$526.15
|
| Rate for Payer: Dignity Health Senior |
$526.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$286.60
|
| Rate for Payer: Heritage Provider Network Senior |
$286.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$309.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$309.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$433.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$433.30
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$223.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$204.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$526.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$526.15
|
| Rate for Payer: Vantage Medical Group Senior |
$526.15
|
|
|
HC GASTROJEJUNOSTOMY SET SGL/LMN
|
Facility
|
IP
|
$619.00
|
|
| Hospital Charge Code |
909001041
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$297.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$248.84
|
| Rate for Payer: Blue Shield of California EPN |
$248.84
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$284.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$286.60
|
| Rate for Payer: Heritage Provider Network Senior |
$286.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$309.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$309.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.75
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$223.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$204.95
|
|
|
HC GASTRO PANEL NUCLEIC ACID
|
Facility
|
OP
|
$1,762.00
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
900913644
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$318.92 |
| Max. Negotiated Rate |
$3,266.96 |
| Rate for Payer: Adventist Health Commercial |
$352.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$941.79
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,210.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,854.59
|
| Rate for Payer: Blue Shield of California Commercial |
$3,266.96
|
| Rate for Payer: Blue Shield of California EPN |
$2,620.37
|
| Rate for Payer: Cash Price |
$969.10
|
| Rate for Payer: Cash Price |
$969.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,145.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Senior |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,145.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$416.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,090.68
|
| Rate for Payer: Heritage Provider Network Senior |
$1,090.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$600.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$840.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$318.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.14
|
| Rate for Payer: Multiplan Commercial |
$1,321.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$416.78
|
| Rate for Payer: TriValley Medical Group Senior |
$416.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$450.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$450.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC GASTRO PANEL NUCLEIC ACID
|
Facility
|
IP
|
$1,762.00
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
900913644
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$318.92 |
| Max. Negotiated Rate |
$1,321.50 |
| Rate for Payer: Adventist Health Commercial |
$352.40
|
| Rate for Payer: Cash Price |
$969.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,192.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,192.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$318.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.50
|
| Rate for Payer: Multiplan Commercial |
$1,321.50
|
|
|
HC GASTROSTOMY TUBE PERCUT
|
Facility
|
OP
|
$2,957.00
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
906743750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$591.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,031.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,626.35
|
| Rate for Payer: Cash Price |
$1,626.35
|
| Rate for Payer: Cash Price |
$1,626.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,922.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,830.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,491.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,410.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$739.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$2,217.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| 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 |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC GASTROSTOMY TUBE PERCUT
|
Facility
|
IP
|
$2,957.00
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
906743750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$535.22 |
| Max. Negotiated Rate |
$2,217.75 |
| Rate for Payer: Adventist Health Commercial |
$591.40
|
| Rate for Payer: Cash Price |
$1,626.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,001.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,001.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$739.25
|
| Rate for Payer: Multiplan Commercial |
$2,217.75
|
|
|
HC GASTROSTOMY TUBE REPOSITION
|
Facility
|
IP
|
$3,174.00
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
906743761
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$574.49 |
| Max. Negotiated Rate |
$2,380.50 |
| Rate for Payer: Adventist Health Commercial |
$634.80
|
| Rate for Payer: Cash Price |
$1,745.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,148.80
|
| Rate for Payer: Heritage Provider Network Senior |
$2,148.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$574.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$793.50
|
| Rate for Payer: Multiplan Commercial |
$2,380.50
|
|
|
HC GASTROSTOMY TUBE REPOSITION
|
Facility
|
OP
|
$3,174.00
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
906743761
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$634.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,180.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,936.14
|
| Rate for Payer: Blue Shield of California EPN |
$1,548.91
|
| Rate for Payer: Cash Price |
$1,745.70
|
| Rate for Payer: Cash Price |
$1,745.70
|
| Rate for Payer: Cash Price |
$1,745.70
|
| Rate for Payer: Cash Price |
$1,745.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,063.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Senior |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$309.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,964.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,964.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$128.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,514.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$574.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$355.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$793.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.37
|
| Rate for Payer: Multiplan Commercial |
$2,380.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$339.92
|
| Rate for Payer: TriValley Medical Group Senior |
$309.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$526.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$443.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC GASTRO TUBE PLACEMENT
|
Facility
|
OP
|
$2,103.00
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
906744500
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$31.36 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$420.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,124.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,444.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,282.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,026.26
|
| Rate for Payer: Cash Price |
$1,156.65
|
| Rate for Payer: Cash Price |
$1,156.65
|
| Rate for Payer: Cash Price |
$1,156.65
|
| Rate for Payer: Cash Price |
$1,156.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,366.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,301.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,301.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,003.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$525.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$1,577.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,310.39
|
| Rate for Payer: TriValley Medical Group Senior |
$1,191.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$526.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$443.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC GASTRO TUBE PLACEMENT
|
Facility
|
IP
|
$2,103.00
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
906744500
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$380.64 |
| Max. Negotiated Rate |
$1,577.25 |
| Rate for Payer: Adventist Health Commercial |
$420.60
|
| Rate for Payer: Cash Price |
$1,156.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,423.73
|
| Rate for Payer: Heritage Provider Network Senior |
$1,423.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$525.75
|
| Rate for Payer: Multiplan Commercial |
$1,577.25
|
|
|
HC GASTRO TUBE REMOVAL
|
Facility
|
IP
|
$5,614.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
900100022
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,016.13 |
| Max. Negotiated Rate |
$4,210.50 |
| Rate for Payer: Adventist Health Commercial |
$1,122.80
|
| Rate for Payer: Cash Price |
$3,087.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,800.68
|
| Rate for Payer: Heritage Provider Network Senior |
$3,800.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,016.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.50
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
|
|
HC GASTRO TUBE REMOVAL
|
Facility
|
OP
|
$5,614.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
900100022
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,122.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,856.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,087.70
|
| Rate for Payer: Cash Price |
$3,087.70
|
| Rate for Payer: Cash Price |
$3,087.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,649.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,475.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,465.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,677.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,016.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| 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 |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC GASTRO UGI SMB W WO KUB
|
Facility
|
OP
|
$1,831.00
|
|
|
Service Code
|
CPT 74245
|
| Hospital Charge Code |
909001811
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$331.41 |
| Max. Negotiated Rate |
$1,556.35 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$978.67
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,257.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,556.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,007.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,373.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,116.91
|
| Rate for Payer: Blue Shield of California EPN |
$893.53
|
| Rate for Payer: Cash Price |
$1,007.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,190.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,556.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,556.35
|
| Rate for Payer: Dignity Health Senior |
$1,556.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,190.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,133.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,133.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$873.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,281.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,281.70
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$915.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$915.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,556.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,556.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,556.35
|
|
|
HC GASTRO UGI SMB W WO KUB
|
Facility
|
IP
|
$1,831.00
|
|
|
Service Code
|
CPT 74245
|
| Hospital Charge Code |
909001811
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$331.41 |
| Max. Negotiated Rate |
$1,373.25 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Cash Price |
$1,007.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,239.59
|
| Rate for Payer: Heritage Provider Network Senior |
$1,239.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.75
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
|
|
HC GASTRO UGI SNGL CNTRST
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
909001873
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.17 |
| Max. Negotiated Rate |
$759.00 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$556.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.12
|
| Rate for Payer: Heritage Provider Network Senior |
$685.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.00
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
|
|
HC GASTRO UGI SNGL CNTRST
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
909001873
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.33 |
| Max. Negotiated Rate |
$759.00 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$540.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.85
|
| Rate for Payer: Blue Shield of California Commercial |
$306.48
|
| Rate for Payer: Blue Shield of California EPN |
$246.46
|
| Rate for Payer: Cash Price |
$556.60
|
| Rate for Payer: Cash Price |
$556.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$657.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Senior |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$657.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$226.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$626.43
|
| Rate for Payer: Heritage Provider Network Senior |
$626.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$165.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$482.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$260.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.00
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$226.19
|
| Rate for Payer: TriValley Medical Group Senior |
$226.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$137.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
