|
HC HEMOGLOBIN A1C (POC)
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
900912157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.53 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.09
|
| Rate for Payer: Heritage Provider Network Senior |
$159.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
|
|
HC HEMOGLOBIN A1C (POC)
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
900912157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$125.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.63
|
| Rate for Payer: Blue Shield of California Commercial |
$78.11
|
| Rate for Payer: Blue Shield of California EPN |
$62.65
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.68
|
| Rate for Payer: Dignity Health Senior |
$9.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$145.47
|
| Rate for Payer: Heritage Provider Network Senior |
$145.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$112.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.23
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.71
|
| Rate for Payer: TriValley Medical Group Senior |
$9.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Vantage Medical Group Senior |
$9.71
|
|
|
HC HEMOGLOBIN CH
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912187
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Adventist Health Commercial |
$16.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$44.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.57
|
| Rate for Payer: Blue Shield of California Commercial |
$19.07
|
| Rate for Payer: Blue Shield of California EPN |
$15.29
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Senior |
$2.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$2.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$51.38
|
| Rate for Payer: Heritage Provider Network Senior |
$51.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$39.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.99
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.37
|
| Rate for Payer: TriValley Medical Group Senior |
$2.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC HEMOGLOBIN CH
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912187
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Adventist Health Commercial |
$16.60
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.19
|
| Rate for Payer: Heritage Provider Network Senior |
$56.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.75
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
|
|
HC HEMOGLOBIN CITRATE
|
Facility
|
OP
|
$67.99
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900910898
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$36.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.82
|
| Rate for Payer: Blue Shield of California Commercial |
$103.62
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$44.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$42.09
|
| Rate for Payer: Heritage Provider Network Senior |
$42.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.22
|
| Rate for Payer: Multiplan Commercial |
$50.99
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC HEMOGLOBIN CITRATE
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900910898
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.27 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.82
|
| Rate for Payer: Heritage Provider Network Senior |
$75.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
OP
|
$67.99
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900910897
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$36.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.82
|
| Rate for Payer: Blue Shield of California Commercial |
$103.62
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$44.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$42.09
|
| Rate for Payer: Heritage Provider Network Senior |
$42.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.22
|
| Rate for Payer: Multiplan Commercial |
$50.99
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900910897
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.27 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.82
|
| Rate for Payer: Heritage Provider Network Senior |
$75.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
|
|
HC HEMOGLOBIN FETAL, STAIN
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
900910133
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$70.62 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.62
|
| Rate for Payer: Blue Shield of California Commercial |
$62.27
|
| Rate for Payer: Blue Shield of California EPN |
$49.94
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.50
|
| Rate for Payer: Dignity Health Senior |
$7.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.33
|
| Rate for Payer: Heritage Provider Network Senior |
$17.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.74
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.73
|
| Rate for Payer: TriValley Medical Group Senior |
$7.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.50
|
| Rate for Payer: Vantage Medical Group Senior |
$7.73
|
|
|
HC HEMOGLOBIN FETAL, STAIN
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
900910133
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$87.06 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$325.64
|
| Rate for Payer: Heritage Provider Network Senior |
$325.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.25
|
| Rate for Payer: Multiplan Commercial |
$360.75
|
|
|
HC HEMOGLOBIN PLASMA
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
900912162
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$66.69 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.69
|
| Rate for Payer: Blue Shield of California Commercial |
$58.81
|
| Rate for Payer: Blue Shield of California EPN |
$47.17
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.04
|
| Rate for Payer: Dignity Health Senior |
$7.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.28
|
| Rate for Payer: Heritage Provider Network Senior |
$22.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.21
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.31
|
| Rate for Payer: TriValley Medical Group Senior |
$7.31
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.04
|
| Rate for Payer: Vantage Medical Group Senior |
$7.31
|
|
|
HC HEMOGLOBIN PLASMA
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
900912162
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.87 |
| Max. Negotiated Rate |
$115.50 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$104.26
|
| Rate for Payer: Heritage Provider Network Senior |
$104.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
|
|
HC HEMOGLOBIN (POC)
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$50.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.57
|
| Rate for Payer: Blue Shield of California Commercial |
$19.07
|
| Rate for Payer: Blue Shield of California EPN |
$15.29
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Senior |
$2.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$2.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Senior |
$58.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$45.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.99
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.37
|
| Rate for Payer: TriValley Medical Group Senior |
$2.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC HEMOGLOBIN (POC)
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$64.31
|
| Rate for Payer: Heritage Provider Network Senior |
$64.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.75
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$161.13
|
| Rate for Payer: Heritage Provider Network Senior |
$161.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.50
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.31 |
| Max. Negotiated Rate |
$146.40 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$90.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$116.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.40
|
| Rate for Payer: Blue Shield of California Commercial |
$38.11
|
| Rate for Payer: Blue Shield of California EPN |
$30.65
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Senior |
$144.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$105.23
|
| Rate for Payer: Heritage Provider Network Senior |
$105.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$81.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC HEMOSTATIC VALVE
|
Facility
|
OP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$51.42 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.38
|
| Rate for Payer: Blue Shield of California Commercial |
$36.91
|
| Rate for Payer: Blue Shield of California EPN |
$29.52
|
| Rate for Payer: Cash Price |
$27.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.42
|
| Rate for Payer: Dignity Health Senior |
$51.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.45
|
| Rate for Payer: Heritage Provider Network Senior |
$37.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.35
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$30.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$30.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.42
|
| Rate for Payer: Vantage Medical Group Senior |
$51.42
|
|
|
HC HEMOSTATIC VALVE
|
Facility
|
IP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$45.38 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$27.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.96
|
| Rate for Payer: Heritage Provider Network Senior |
$40.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$35.11 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$131.34
|
| Rate for Payer: Heritage Provider Network Senior |
$131.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.50
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.15 |
| Max. Negotiated Rate |
$78.43 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$18.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.43
|
| Rate for Payer: Blue Shield of California Commercial |
$74.76
|
| Rate for Payer: Blue Shield of California EPN |
$59.97
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$22.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.02
|
| Rate for Payer: Dignity Health Senior |
$11.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.05
|
| Rate for Payer: Heritage Provider Network Senior |
$21.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.92
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.84
|
| Rate for Payer: TriValley Medical Group Senior |
$11.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Vantage Medical Group Senior |
$11.84
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
OP
|
$64.81
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$74.62 |
| Rate for Payer: Adventist Health Commercial |
$12.96
|
| Rate for Payer: Aetna of CA Gatekeeper |
$34.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.62
|
| Rate for Payer: Blue Shield of California Commercial |
$65.78
|
| Rate for Payer: Blue Shield of California EPN |
$52.76
|
| Rate for Payer: Cash Price |
$29.16
|
| Rate for Payer: Cash Price |
$29.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Senior |
$8.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.13
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.12
|
| Rate for Payer: Heritage Provider Network Senior |
$40.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.29
|
| Rate for Payer: Multiplan Commercial |
$48.61
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.17
|
| Rate for Payer: TriValley Medical Group Senior |
$8.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.17
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
IP
|
$403.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.94 |
| Max. Negotiated Rate |
$302.25 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$272.83
|
| Rate for Payer: Heritage Provider Network Senior |
$272.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.75
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
|
|
HC HEPATIC W/HEMODYNAMI
|
Facility
|
OP
|
$7,293.00
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
909081643
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,320.03 |
| Max. Negotiated Rate |
$5,998.81 |
| Rate for Payer: Adventist Health Commercial |
$1,458.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,898.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,010.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.28
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$3,281.85
|
| Rate for Payer: Cash Price |
$3,281.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,740.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,740.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,514.37
|
| Rate for Payer: Heritage Provider Network Senior |
$4,514.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,478.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,320.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$5,469.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,999.21
|
| Rate for Payer: TriValley Medical Group Senior |
$3,999.21
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC HEPATIC W/HEMODYNAMI
|
Facility
|
IP
|
$7,293.00
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
909081643
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,320.03 |
| Max. Negotiated Rate |
$5,469.75 |
| Rate for Payer: Adventist Health Commercial |
$1,458.60
|
| Rate for Payer: Cash Price |
$3,281.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,937.36
|
| Rate for Payer: Heritage Provider Network Senior |
$4,937.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,320.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.25
|
| Rate for Payer: Multiplan Commercial |
$5,469.75
|
|
|
HC HEPATIC W/O HEMODYNA
|
Facility
|
OP
|
$6,157.00
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
909081662
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,114.42 |
| Max. Negotiated Rate |
$5,998.81 |
| Rate for Payer: Adventist Health Commercial |
$1,231.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,290.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,229.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.28
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$2,770.65
|
| Rate for Payer: Cash Price |
$2,770.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,002.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,002.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.18
|
| Rate for Payer: Heritage Provider Network Senior |
$3,811.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,936.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,539.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$4,617.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,999.21
|
| Rate for Payer: TriValley Medical Group Senior |
$3,999.21
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
