|
HC LAY CLOS OF WNDS 20.1-30.0 CM
|
Facility
|
IP
|
$1,767.00
|
|
|
Service Code
|
CPT 12056
|
| Hospital Charge Code |
900501525
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$319.83 |
| Max. Negotiated Rate |
$1,325.25 |
| Rate for Payer: Adventist Health Commercial |
$353.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,213.93
|
| Rate for Payer: Cash Price |
$795.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,196.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,196.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.75
|
| Rate for Payer: Multiplan Commercial |
$1,325.25
|
|
|
HC LAY CLOS OF WNDS 2.6-5.0 CM
|
Facility
|
OP
|
$896.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
900501036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.18 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$179.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$615.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$582.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$606.59
|
| Rate for Payer: Heritage Provider Network Senior |
$606.59
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$431.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$162.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$672.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$325.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$299.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS 2.6-5.0 CM
|
Facility
|
IP
|
$896.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
900501036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.18 |
| Max. Negotiated Rate |
$672.00 |
| Rate for Payer: Adventist Health Commercial |
$179.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$615.55
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$606.59
|
| Rate for Payer: Heritage Provider Network Senior |
$606.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$162.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.00
|
| Rate for Payer: Multiplan Commercial |
$672.00
|
|
|
HC LAY CLOS OF WNDS 2.6-7.5 CM
|
Facility
|
OP
|
$804.00
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
900501034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$522.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$387.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$603.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$291.93
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$268.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS 2.6-7.5 CM
|
Facility
|
IP
|
$804.00
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
900501034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$603.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| Rate for Payer: Multiplan Commercial |
$603.00
|
|
|
HC LAY CLOS OF WNDS 5.1-7.5 CM
|
Facility
|
OP
|
$1,008.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
900501037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.45 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$201.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$692.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$655.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$682.42
|
| Rate for Payer: Heritage Provider Network Senior |
$682.42
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$485.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$756.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$366.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$336.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS 5.1-7.5 CM
|
Facility
|
IP
|
$1,008.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
900501037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.45 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Adventist Health Commercial |
$201.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$692.50
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$682.42
|
| Rate for Payer: Heritage Provider Network Senior |
$682.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.00
|
| Rate for Payer: Multiplan Commercial |
$756.00
|
|
|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
|
OP
|
$2,004.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$362.72 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$400.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,376.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,302.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,356.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,356.71
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$965.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$1,503.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$727.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$669.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
|
IP
|
$2,004.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$362.72 |
| Max. Negotiated Rate |
$1,503.00 |
| Rate for Payer: Adventist Health Commercial |
$400.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,376.75
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,356.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,356.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.00
|
| Rate for Payer: Multiplan Commercial |
$1,503.00
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
|
IP
|
$691.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.07 |
| Max. Negotiated Rate |
$518.25 |
| Rate for Payer: Adventist Health Commercial |
$138.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$474.72
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$467.81
|
| Rate for Payer: Heritage Provider Network Senior |
$467.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.75
|
| Rate for Payer: Multiplan Commercial |
$518.25
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
|
OP
|
$691.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.07 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$138.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$474.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cash Price |
$310.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$449.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$467.81
|
| Rate for Payer: Heritage Provider Network Senior |
$467.81
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$333.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$518.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$250.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$230.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.18 |
| Max. Negotiated Rate |
$41,128.50 |
| Rate for Payer: Adventist Health Commercial |
$10,967.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37,673.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35,644.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,944.72
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$436.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,925.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,709.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$50,255.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.18 |
| Max. Negotiated Rate |
$37,691.25 |
| Rate for Payer: Adventist Health Commercial |
$10,051.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,525.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,665.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: Dignity Health Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,341.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$31,107.84
|
| Rate for Payer: Heritage Provider Network Senior |
$16,410.39
|
| Rate for Payer: Humana Medicare |
$13,341.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$436.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25,349.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,096.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,743.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,563.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,810.64
|
| Rate for Payer: Multiplan Commercial |
$37,691.25
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,675.96
|
| Rate for Payer: TriValley Medical Group Senior |
$14,675.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$50,255.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,096.16 |
| Max. Negotiated Rate |
$37,691.25 |
| Rate for Payer: Adventist Health Commercial |
$10,051.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,525.18
|
| Rate for Payer: Cash Price |
$22,614.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$34,022.64
|
| Rate for Payer: Heritage Provider Network Senior |
$34,022.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,096.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,563.75
|
| Rate for Payer: Multiplan Commercial |
$37,691.25
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$54,838.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906820135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,925.68 |
| Max. Negotiated Rate |
$41,128.50 |
| Rate for Payer: Adventist Health Commercial |
$10,967.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37,673.71
|
| Rate for Payer: Cash Price |
$24,677.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,125.33
|
| Rate for Payer: Heritage Provider Network Senior |
$37,125.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,925.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,709.50
|
| Rate for Payer: Multiplan Commercial |
$41,128.50
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$57,375.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$48,768.75 |
| Rate for Payer: Adventist Health Commercial |
$11,475.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,416.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48,768.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,556.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43,031.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,293.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,768.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,768.75
|
| Rate for Payer: Dignity Health Senior |
$48,768.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,515.12
|
| Rate for Payer: Heritage Provider Network Senior |
$35,515.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$403.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,654.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,384.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,343.75
|
| Rate for Payer: Multiplan Commercial |
$43,031.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,768.75
|
| Rate for Payer: Vantage Medical Group Senior |
$48,768.75
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
OP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$42,012.95 |
| Rate for Payer: Adventist Health Commercial |
$9,885.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,956.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,184.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37,070.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,379.37
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.32
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,127.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,012.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,012.95
|
| Rate for Payer: Dignity Health Senior |
$42,012.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,595.31
|
| Rate for Payer: Heritage Provider Network Senior |
$30,595.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$403.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23,823.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,946.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,356.75
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,865.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,024.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42,012.95
|
| Rate for Payer: Vantage Medical Group Senior |
$42,012.95
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$57,375.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906812215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,384.88 |
| Max. Negotiated Rate |
$43,031.25 |
| Rate for Payer: Adventist Health Commercial |
$11,475.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,416.62
|
| Rate for Payer: Cash Price |
$25,818.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,842.88
|
| Rate for Payer: Heritage Provider Network Senior |
$38,842.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,384.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,343.75
|
| Rate for Payer: Multiplan Commercial |
$43,031.25
|
|
|
HC LEAD INSERT CS INITIAL IMPL
|
Facility
|
IP
|
$49,427.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
906820136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,946.29 |
| Max. Negotiated Rate |
$37,070.25 |
| Rate for Payer: Adventist Health Commercial |
$9,885.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,956.35
|
| Rate for Payer: Cash Price |
$22,242.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,462.08
|
| Rate for Payer: Heritage Provider Network Senior |
$33,462.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,946.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,356.75
|
| Rate for Payer: Multiplan Commercial |
$37,070.25
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$15,189.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,434.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,872.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,401.99
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$98.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,749.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,797.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,875.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,357.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$98.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906820117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,028.49 |
| Max. Negotiated Rate |
$12,549.00 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,327.56
|
| Rate for Payer: Heritage Provider Network Senior |
$11,327.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
|
|
HC LEAD INSERT DUAL A & V
|
Facility
|
IP
|
$15,189.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
906811360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,749.21 |
| Max. Negotiated Rate |
$11,391.75 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,434.84
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,282.95
|
| Rate for Payer: Heritage Provider Network Senior |
$10,282.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,749.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,797.25
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
IP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,028.49 |
| Max. Negotiated Rate |
$12,549.00 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,327.56
|
| Rate for Payer: Heritage Provider Network Senior |
$11,327.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
|
|
HC LEAD INSERT, SINGLE A OR V
|
Facility
|
OP
|
$16,732.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
906820112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$696.95 |
| Max. Negotiated Rate |
$20,168.10 |
| Rate for Payer: Adventist Health Commercial |
$3,346.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,494.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,131.19
|
| Rate for Payer: Blue Shield of California EPN |
$12,145.11
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cash Price |
$7,529.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,875.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: Dignity Health Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,614.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,357.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13,056.19
|
| Rate for Payer: Humana Medicare |
$10,614.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$696.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20,168.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,028.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,525.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,183.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,374.64
|
| Rate for Payer: Multiplan Commercial |
$12,549.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,676.27
|
| Rate for Payer: TriValley Medical Group Senior |
$11,676.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
