|
HC GUIDEWIRE, TRANSEND
|
Facility
|
OP
|
$1,108.60
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909020096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$200.66 |
| Max. Negotiated Rate |
$942.31 |
| Rate for Payer: Adventist Health Commercial |
$221.72
|
| Rate for Payer: Aetna of CA Gatekeeper |
$592.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$761.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$942.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$609.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.45
|
| Rate for Payer: Blue Shield of California Commercial |
$676.25
|
| Rate for Payer: Blue Shield of California EPN |
$541.00
|
| Rate for Payer: Cash Price |
$609.73
|
| Rate for Payer: Cigna of CA HMO/PPO |
$720.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$942.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$942.31
|
| Rate for Payer: Dignity Health Senior |
$942.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$720.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$686.22
|
| Rate for Payer: Heritage Provider Network Senior |
$686.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$528.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$776.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$776.02
|
| Rate for Payer: Multiplan Commercial |
$831.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$554.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$554.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$942.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$942.31
|
| Rate for Payer: Vantage Medical Group Senior |
$942.31
|
|
|
HC GWIRE COONS .035 145CM G02356
|
Facility
|
IP
|
$210.60
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$157.95 |
| Rate for Payer: Adventist Health Commercial |
$42.12
|
| Rate for Payer: Cash Price |
$115.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.58
|
| Rate for Payer: Heritage Provider Network Senior |
$142.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.65
|
| Rate for Payer: Multiplan Commercial |
$157.95
|
|
|
HC GWIRE COONS .035 145CM G02356
|
Facility
|
OP
|
$210.60
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Adventist Health Commercial |
$42.12
|
| Rate for Payer: Aetna of CA Gatekeeper |
$112.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$144.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$179.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.95
|
| Rate for Payer: Blue Shield of California Commercial |
$128.47
|
| Rate for Payer: Blue Shield of California EPN |
$102.77
|
| Rate for Payer: Cash Price |
$115.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$136.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$179.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$179.01
|
| Rate for Payer: Dignity Health Senior |
$179.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$130.36
|
| Rate for Payer: Heritage Provider Network Senior |
$130.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.42
|
| Rate for Payer: Multiplan Commercial |
$157.95
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$105.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$105.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$179.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$179.01
|
| Rate for Payer: Vantage Medical Group Senior |
$179.01
|
|
|
HC GWIRE COONS .035 180CM G02621
|
Facility
|
IP
|
$183.89
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000031
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$137.92 |
| Rate for Payer: Adventist Health Commercial |
$36.78
|
| Rate for Payer: Cash Price |
$101.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$124.49
|
| Rate for Payer: Heritage Provider Network Senior |
$124.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.97
|
| Rate for Payer: Multiplan Commercial |
$137.92
|
|
|
HC GWIRE COONS .035 180CM G02621
|
Facility
|
OP
|
$183.89
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000031
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$156.31 |
| Rate for Payer: Adventist Health Commercial |
$36.78
|
| Rate for Payer: Aetna of CA Gatekeeper |
$98.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$126.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$156.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.92
|
| Rate for Payer: Blue Shield of California Commercial |
$112.17
|
| Rate for Payer: Blue Shield of California EPN |
$89.74
|
| Rate for Payer: Cash Price |
$101.14
|
| Rate for Payer: Cigna of CA HMO/PPO |
$119.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.31
|
| Rate for Payer: Dignity Health Senior |
$156.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$113.83
|
| Rate for Payer: Heritage Provider Network Senior |
$113.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$87.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$128.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$128.72
|
| Rate for Payer: Multiplan Commercial |
$137.92
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$91.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$91.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$156.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.31
|
| Rate for Payer: Vantage Medical Group Senior |
$156.31
|
|
|
HC GWIRE FATHOM 300CMX10CM
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000769
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$326.16 |
| Max. Negotiated Rate |
$1,531.70 |
| Rate for Payer: Adventist Health Commercial |
$360.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$963.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,237.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,531.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$991.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,351.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,099.22
|
| Rate for Payer: Blue Shield of California EPN |
$879.38
|
| Rate for Payer: Cash Price |
$991.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,171.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,531.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,531.70
|
| Rate for Payer: Dignity Health Senior |
$1,531.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,171.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,115.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,115.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$859.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$326.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,261.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,261.40
|
| Rate for Payer: Multiplan Commercial |
$1,351.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$901.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$901.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,531.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,531.70
|
| Rate for Payer: Vantage Medical Group Senior |
$1,531.70
|
|
|
HC GWIRE FATHOM 300CMX10CM
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000769
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$326.16 |
| Max. Negotiated Rate |
$1,351.50 |
| Rate for Payer: Adventist Health Commercial |
$360.40
|
| Rate for Payer: Cash Price |
$991.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,219.95
|
| Rate for Payer: Heritage Provider Network Senior |
$1,219.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$326.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.50
|
| Rate for Payer: Multiplan Commercial |
$1,351.50
|
|
|
HC HALO ADDITION MRI COMPATIBLE
|
Facility
|
OP
|
$2,933.00
|
|
|
Service Code
|
CPT L0859
|
| Hospital Charge Code |
905350860
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$733.25 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$1,202.53
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,407.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,014.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,493.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,613.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,199.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,179.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.07
|
| Rate for Payer: Cash Price |
$1,613.15
|
| Rate for Payer: Cash Price |
$1,613.15
|
| Rate for Payer: Cash Price |
$1,613.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,349.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,493.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,493.05
|
| Rate for Payer: Dignity Health Senior |
$2,493.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,877.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,357.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,357.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,188.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,466.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,466.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,466.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$733.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,053.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,053.10
|
| Rate for Payer: Multiplan Commercial |
$2,199.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,059.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$971.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,493.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,493.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,493.05
|
|
|
HC HALO ADDITION MRI COMPATIBLE
|
Facility
|
IP
|
$2,933.00
|
|
|
Service Code
|
CPT L0859
|
| Hospital Charge Code |
905350860
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$586.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$586.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,407.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,179.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.07
|
| Rate for Payer: Cash Price |
$1,613.15
|
| Rate for Payer: Cash Price |
$1,613.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,349.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,357.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,357.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,466.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,466.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,466.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$733.25
|
| Rate for Payer: Multiplan Commercial |
$2,199.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,059.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$971.12
|
|
|
HC HALO ADDITION MRI COMPATIBLE SYSTEM
|
Facility
|
IP
|
$2,210.00
|
|
|
Service Code
|
CPT L0859
|
| Hospital Charge Code |
905350859
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$442.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,060.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$888.42
|
| Rate for Payer: Blue Shield of California EPN |
$888.42
|
| Rate for Payer: Cash Price |
$1,215.50
|
| Rate for Payer: Cash Price |
$1,215.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,016.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,193.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,023.23
|
| Rate for Payer: Heritage Provider Network Senior |
$1,023.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,105.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,105.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,105.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.50
|
| Rate for Payer: Multiplan Commercial |
$1,657.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$798.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$731.73
|
|
|
HC HALO ADDITION MRI COMPATIBLE SYSTEM
|
Facility
|
OP
|
$2,210.00
|
|
|
Service Code
|
CPT L0859
|
| Hospital Charge Code |
905350859
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$552.50 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$906.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,060.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,518.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,878.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,215.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,657.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$888.42
|
| Rate for Payer: Blue Shield of California EPN |
$888.42
|
| Rate for Payer: Cash Price |
$1,215.50
|
| Rate for Payer: Cash Price |
$1,215.50
|
| Rate for Payer: Cash Price |
$1,215.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,016.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,878.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,878.50
|
| Rate for Payer: Dignity Health Senior |
$1,878.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,414.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,023.23
|
| Rate for Payer: Heritage Provider Network Senior |
$1,023.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,188.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,105.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,105.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,105.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,547.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,547.00
|
| Rate for Payer: Multiplan Commercial |
$1,657.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$798.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$731.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,878.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,878.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,878.50
|
|
|
HC HALO PROCEDURE, W/VEST
|
Facility
|
OP
|
$11,190.00
|
|
|
Service Code
|
CPT L0810
|
| Hospital Charge Code |
905350810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,797.50 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$4,587.90
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,371.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,687.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,511.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,154.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,392.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,498.38
|
| Rate for Payer: Blue Shield of California EPN |
$4,498.38
|
| Rate for Payer: Cash Price |
$6,154.50
|
| Rate for Payer: Cash Price |
$6,154.50
|
| Rate for Payer: Cash Price |
$6,154.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,147.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,511.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,511.50
|
| Rate for Payer: Dignity Health Senior |
$9,511.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,161.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,180.97
|
| Rate for Payer: Heritage Provider Network Senior |
$5,180.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,015.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,595.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,595.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,595.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,797.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,833.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,833.00
|
| Rate for Payer: Multiplan Commercial |
$8,392.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,042.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,705.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,511.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,511.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,511.50
|
|
|
HC HALO PROCEDURE, W/VEST
|
Facility
|
IP
|
$11,190.00
|
|
|
Service Code
|
CPT L0810
|
| Hospital Charge Code |
905350810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,238.00 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$2,238.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,371.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,498.38
|
| Rate for Payer: Blue Shield of California EPN |
$4,498.38
|
| Rate for Payer: Cash Price |
$6,154.50
|
| Rate for Payer: Cash Price |
$6,154.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,147.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,042.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,180.97
|
| Rate for Payer: Heritage Provider Network Senior |
$5,180.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,595.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,595.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,595.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,797.50
|
| Rate for Payer: Multiplan Commercial |
$8,392.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,042.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,705.01
|
|
|
HC HALO REPL LINER/INTERFACE
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT L0861
|
| Hospital Charge Code |
905350861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$162.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$136.28
|
| Rate for Payer: Blue Shield of California EPN |
$136.28
|
| Rate for Payer: Cash Price |
$186.45
|
| Rate for Payer: Cash Price |
$186.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$155.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$156.96
|
| Rate for Payer: Heritage Provider Network Senior |
$156.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$169.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.75
|
| Rate for Payer: Multiplan Commercial |
$254.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$122.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$112.24
|
|
|
HC HALO REPL LINER/INTERFACE
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT L0861
|
| Hospital Charge Code |
905350861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$84.75 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA Gatekeeper |
$162.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$232.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$136.28
|
| Rate for Payer: Blue Shield of California EPN |
$136.28
|
| Rate for Payer: Cash Price |
$186.45
|
| Rate for Payer: Cash Price |
$186.45
|
| Rate for Payer: Cash Price |
$186.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$155.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Senior |
$288.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$216.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$156.96
|
| Rate for Payer: Heritage Provider Network Senior |
$156.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$219.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$169.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$254.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$122.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$112.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC HALO/TONGS REMOVAL
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 20665
|
| Hospital Charge Code |
900501562
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Cash Price |
$261.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC HALO/TONGS REMOVAL
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 20665
|
| Hospital Charge Code |
900501562
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$327.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$261.80
|
| Rate for Payer: Cash Price |
$261.80
|
| Rate for Payer: Cash Price |
$261.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Senior |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$507.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$227.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$638.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$638.85
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$171.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$157.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
|
HC HAND COMPLETE MIN 3 VIEWS
|
Facility
|
IP
|
$655.00
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
909001520
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.56 |
| Max. Negotiated Rate |
$491.25 |
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$443.44
|
| Rate for Payer: Heritage Provider Network Senior |
$443.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.75
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
|
|
HC HAND COMPLETE MIN 3 VIEWS
|
Facility
|
OP
|
$655.00
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
909001520
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.73 |
| Max. Negotiated Rate |
$491.25 |
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$350.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$449.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138.54
|
| Rate for Payer: Blue Shield of California Commercial |
$109.97
|
| Rate for Payer: Blue Shield of California EPN |
$88.43
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$425.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$405.44
|
| Rate for Payer: Heritage Provider Network Senior |
$405.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$312.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC HAND LIMITED 2 VIEWS
|
Facility
|
OP
|
$453.00
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
909001518
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.03 |
| Max. Negotiated Rate |
$339.75 |
| Rate for Payer: Adventist Health Commercial |
$90.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$242.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$311.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.83
|
| Rate for Payer: Blue Shield of California Commercial |
$101.86
|
| Rate for Payer: Blue Shield of California EPN |
$81.91
|
| Rate for Payer: Cash Price |
$249.15
|
| Rate for Payer: Cash Price |
$249.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$294.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$280.41
|
| Rate for Payer: Heritage Provider Network Senior |
$280.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$216.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$339.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC HAND LIMITED 2 VIEWS
|
Facility
|
IP
|
$453.00
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
909001518
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$81.99 |
| Max. Negotiated Rate |
$339.75 |
| Rate for Payer: Adventist Health Commercial |
$90.60
|
| Rate for Payer: Cash Price |
$249.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$306.68
|
| Rate for Payer: Heritage Provider Network Senior |
$306.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.25
|
| Rate for Payer: Multiplan Commercial |
$339.75
|
|
|
HC HAND MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 95832
|
| Hospital Charge Code |
900400010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$125.46
|
| Rate for Payer: Aetna of CA Gatekeeper |
$163.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$210.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$260.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$168.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$198.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$260.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$260.10
|
| Rate for Payer: Dignity Health Senior |
$260.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$198.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$189.41
|
| Rate for Payer: Heritage Provider Network Senior |
$189.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$145.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$214.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$214.20
|
| Rate for Payer: Multiplan Commercial |
$229.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$260.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$260.10
|
| Rate for Payer: Vantage Medical Group Senior |
$260.10
|
|
|
HC HAND MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 95832
|
| Hospital Charge Code |
900400010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$61.20
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$207.16
|
| Rate for Payer: Heritage Provider Network Senior |
$207.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.50
|
| Rate for Payer: Multiplan Commercial |
$229.50
|
|
|
HC HAND MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 95832
|
| Hospital Charge Code |
901300025
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$61.20
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$207.16
|
| Rate for Payer: Heritage Provider Network Senior |
$207.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.50
|
| Rate for Payer: Multiplan Commercial |
$229.50
|
|
|
HC HAND MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 95832
|
| Hospital Charge Code |
901300025
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$125.46
|
| Rate for Payer: Aetna of CA Gatekeeper |
$163.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$210.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$260.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$168.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$198.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$260.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$260.10
|
| Rate for Payer: Dignity Health Senior |
$260.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$198.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$189.41
|
| Rate for Payer: Heritage Provider Network Senior |
$189.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$145.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$214.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$214.20
|
| Rate for Payer: Multiplan Commercial |
$229.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$260.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$260.10
|
| Rate for Payer: Vantage Medical Group Senior |
$260.10
|
|
