|
HC ERCP W/SPHINCTERTMY
|
Facility
|
OP
|
$4,498.00
|
|
|
Service Code
|
CPT 43262
|
| Hospital Charge Code |
906743262
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$899.60
|
| Rate for Payer: Adventist Health Commercial |
$720.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,225.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,779.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Cash Price |
$1,620.45
|
| Rate for Payer: Cash Price |
$1,620.45
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Cash Price |
$1,620.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,340.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,923.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,958.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,958.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,784.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,229.02
|
| Rate for Payer: Heritage Provider Network Senior |
$6,099.30
|
| Rate for Payer: Heritage Provider Network Senior |
$6,099.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,717.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,145.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$814.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$651.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,702.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,702.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$900.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,124.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$3,373.50
|
| Rate for Payer: Multiplan Commercial |
$2,700.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ESBL DISK CONFIRMATION
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912449
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$65.39 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$129.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.39
|
| Rate for Payer: Blue Shield of California Commercial |
$55.47
|
| Rate for Payer: Blue Shield of California Commercial |
$55.47
|
| Rate for Payer: Blue Shield of California EPN |
$44.49
|
| Rate for Payer: Blue Shield of California EPN |
$44.49
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$136.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$129.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.47
|
| Rate for Payer: Heritage Provider Network Senior |
$129.99
|
| Rate for Payer: Heritage Provider Network Senior |
$28.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$100.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$21.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.02
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
|
|
HC ESBL DISK CONFIRMATION
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912449
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.01 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$135.24
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.17
|
| Rate for Payer: Heritage Provider Network Senior |
$142.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
|
|
HC ESD INCL ENDSCPY OR CLNSCPY, MCSL CLSR
|
Facility
|
OP
|
$6,356.00
|
|
|
Service Code
|
CPT C9779
|
| Hospital Charge Code |
906749779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,150.44 |
| Max. Negotiated Rate |
$9,421.68 |
| Rate for Payer: Adventist Health Commercial |
$1,271.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,928.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,179.27
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,131.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,813.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,958.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,934.36
|
| Rate for Payer: Heritage Provider Network Senior |
$6,099.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9,421.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,150.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,702.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,589.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$4,767.00
|
| Rate for Payer: Multiplan WC |
$7,702.17
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,454.66
|
| Rate for Payer: TriValley Medical Group Senior |
$5,454.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ESD INCL ENDSCPY OR CLNSCPY, MCSL CLSR
|
Facility
|
IP
|
$6,356.00
|
|
|
Service Code
|
CPT C9779
|
| Hospital Charge Code |
906749779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,150.44 |
| Max. Negotiated Rate |
$4,767.00 |
| Rate for Payer: Adventist Health Commercial |
$1,271.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,093.26
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,303.01
|
| Rate for Payer: Heritage Provider Network Senior |
$4,303.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,150.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,589.00
|
| Rate for Payer: Multiplan Commercial |
$4,767.00
|
|
|
HC ESOPH ACID REFLX TEST
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791033
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$596.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,289.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,043.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$483.19
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,356.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$627.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$479.94
|
| Rate for Payer: EPIC Health Plan Medicare |
$479.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$597.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,291.85
|
| Rate for Payer: Heritage Provider Network Senior |
$590.33
|
| Rate for Payer: Heritage Provider Network Senior |
$590.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$995.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$460.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$377.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$551.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$551.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Multiplan Commercial |
$1,565.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC ESOPH ACID REFLX TEST
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791033
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$622.10
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.98
|
| Rate for Payer: Heritage Provider Network Senior |
$653.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
|
|
HC ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
OP
|
$3,057.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$553.32 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$611.40
|
| Rate for Payer: Adventist Health Commercial |
$914.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,889.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,826.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,987.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,973.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,831.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,892.28
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,689.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,689.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$827.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$553.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,143.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$3,430.50
|
| Rate for Payer: Multiplan Commercial |
$2,292.75
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,714.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,714.84
|
| Rate for Payer: TriValley Medical Group Senior |
$2,714.84
|
| Rate for Payer: TriValley Medical Group Senior |
$2,714.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
IP
|
$4,574.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$827.89 |
| Max. Negotiated Rate |
$3,430.50 |
| Rate for Payer: Adventist Health Commercial |
$914.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,945.66
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,096.60
|
| Rate for Payer: Heritage Provider Network Senior |
$3,096.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$827.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,143.50
|
| Rate for Payer: Multiplan Commercial |
$3,430.50
|
|
|
HC ESOPHAGEAL DILATATION
|
Facility
|
OP
|
$1,803.00
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
909001829
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.34 |
| Max. Negotiated Rate |
$1,532.55 |
| Rate for Payer: Adventist Health Commercial |
$360.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,114.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,532.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$991.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,352.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$850.87
|
| Rate for Payer: Blue Shield of California Commercial |
$664.90
|
| Rate for Payer: Blue Shield of California EPN |
$534.69
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,171.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,532.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,532.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,532.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,063.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,116.06
|
| Rate for Payer: Heritage Provider Network Senior |
$1,116.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$860.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,262.10
|
| Rate for Payer: Multiplan Commercial |
$1,352.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$901.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$901.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,532.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,532.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,532.55
|
|
|
HC ESOPHAGEAL DILATATION
|
Facility
|
IP
|
$1,803.00
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
909001829
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.34 |
| Max. Negotiated Rate |
$1,352.25 |
| Rate for Payer: Adventist Health Commercial |
$360.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,161.13
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,220.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,220.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.75
|
| Rate for Payer: Multiplan Commercial |
$1,352.25
|
|
|
HC ESOPHAGOGASTRIC TMPONAD W/BLLN
|
Facility
|
IP
|
$6,570.00
|
|
|
Service Code
|
CPT 43460
|
| Hospital Charge Code |
906743460
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,189.17 |
| Max. Negotiated Rate |
$4,927.50 |
| Rate for Payer: Adventist Health Commercial |
$1,314.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,231.08
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,447.89
|
| Rate for Payer: Heritage Provider Network Senior |
$4,447.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,189.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,642.50
|
| Rate for Payer: Multiplan Commercial |
$4,927.50
|
|
|
HC ESOPHAGOGASTRIC TMPONAD W/BLLN
|
Facility
|
OP
|
$4,353.00
|
|
|
Service Code
|
CPT 43460
|
| Hospital Charge Code |
906743460
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$870.60
|
| Rate for Payer: Adventist Health Commercial |
$1,314.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,060.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,690.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,584.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,700.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,394.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,613.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,264.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,927.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,958.85
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Cash Price |
$1,958.85
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,270.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,829.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,700.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,584.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,700.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,584.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,584.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,700.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,694.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,066.83
|
| Rate for Payer: Heritage Provider Network Senior |
$4,066.83
|
| Rate for Payer: Heritage Provider Network Senior |
$2,694.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,076.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,133.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$787.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,189.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,642.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,088.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,047.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,599.00
|
| Rate for Payer: Multiplan Commercial |
$4,927.50
|
| Rate for Payer: Multiplan Commercial |
$3,264.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,584.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,584.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Senior |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Senior |
$5,584.50
|
|
|
HC ESOPHAGOSCOPY RIGID TRANSORAL
|
Facility
|
IP
|
$11,735.00
|
|
|
Service Code
|
CPT 43180
|
| Hospital Charge Code |
906743180
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,124.03 |
| Max. Negotiated Rate |
$8,801.25 |
| Rate for Payer: Adventist Health Commercial |
$2,347.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,557.34
|
| Rate for Payer: Cash Price |
$5,280.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,944.60
|
| Rate for Payer: Heritage Provider Network Senior |
$7,944.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,124.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,933.75
|
| Rate for Payer: Multiplan Commercial |
$8,801.25
|
|
|
HC ESOPHAGOSCOPY RIGID TRANSORAL
|
Facility
|
OP
|
$11,735.00
|
|
|
Service Code
|
CPT 43180
|
| Hospital Charge Code |
906743180
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$11,420.83 |
| Rate for Payer: Adventist Health Commercial |
$2,347.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,252.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,280.75
|
| Rate for Payer: Cash Price |
$5,280.75
|
| Rate for Payer: Cash Price |
$5,280.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,627.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,613.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,263.97
|
| Rate for Payer: Heritage Provider Network Senior |
$9,365.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,597.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,124.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,755.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,933.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan Commercial |
$8,801.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
|
|
HC ESOPHAGOSCOPY W BLLN LT 30MM
|
Facility
|
IP
|
$3,352.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
900501292
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$606.71 |
| Max. Negotiated Rate |
$2,514.00 |
| Rate for Payer: Adventist Health Commercial |
$670.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,158.69
|
| Rate for Payer: Cash Price |
$1,508.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,269.30
|
| Rate for Payer: Heritage Provider Network Senior |
$2,269.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$606.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$838.00
|
| Rate for Payer: Multiplan Commercial |
$2,514.00
|
|
|
HC ESOPHAGOSCOPY W BLLN LT 30MM
|
Facility
|
OP
|
$3,352.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
900501292
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$606.71 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$670.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,071.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,592.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,267.06
|
| Rate for Payer: Cash Price |
$1,508.40
|
| Rate for Payer: Cash Price |
$1,508.40
|
| Rate for Payer: Cash Price |
$1,508.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,178.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,269.30
|
| Rate for Payer: Heritage Provider Network Senior |
$2,269.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,598.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$606.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$838.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,514.00
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,011.20
|
| Rate for Payer: TriValley Medical Group Senior |
$2,011.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ESOPHAGOSCOPY W OPTICAL ENDOMI
|
Facility
|
OP
|
$3,053.00
|
|
|
Service Code
|
CPT 43206
|
| Hospital Charge Code |
906743206
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$610.60
|
| Rate for Payer: Adventist Health Commercial |
$408.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,261.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,886.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,373.85
|
| Rate for Payer: Cash Price |
$1,373.85
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cash Price |
$1,373.85
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,326.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,984.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,889.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,263.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$973.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,456.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$552.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$369.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$763.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,289.75
|
| Rate for Payer: Multiplan Commercial |
$1,530.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ESOPHAGOSCOPY W OPTICAL ENDOMI
|
Facility
|
IP
|
$3,053.00
|
|
|
Service Code
|
CPT 43206
|
| Hospital Charge Code |
906743206
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$552.59 |
| Max. Negotiated Rate |
$2,289.75 |
| Rate for Payer: Adventist Health Commercial |
$610.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,966.13
|
| Rate for Payer: Cash Price |
$1,373.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,066.88
|
| Rate for Payer: Heritage Provider Network Senior |
$2,066.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$552.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$763.25
|
| Rate for Payer: Multiplan Commercial |
$2,289.75
|
|
|
HC ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
IP
|
$3,368.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$609.61 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,168.99
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,280.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,280.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$609.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
|
|
HC ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
OP
|
$3,070.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$555.67 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$614.00
|
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,081.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,897.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,458.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,599.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,160.46
|
| Rate for Payer: Blue Shield of California EPN |
$1,273.10
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,995.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,189.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,280.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,078.39
|
| Rate for Payer: Heritage Provider Network Senior |
$2,280.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,078.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,606.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,464.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$609.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$555.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$767.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Multiplan Commercial |
$2,302.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,842.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,020.80
|
| Rate for Payer: TriValley Medical Group Senior |
$2,020.80
|
| Rate for Payer: TriValley Medical Group Senior |
$1,842.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
OP
|
$3,368.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Commercial |
$614.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,897.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,081.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,995.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,189.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,084.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,900.33
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,464.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,606.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$609.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$555.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$767.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Multiplan Commercial |
$2,302.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
IP
|
$3,368.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$609.61 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,168.99
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,280.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,280.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$609.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
|
|
HC ESOPHAGUS CELLVIZIO
|
Facility
|
IP
|
$5,727.00
|
|
|
Service Code
|
CPT 43499
|
| Hospital Charge Code |
906743499
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,036.59 |
| Max. Negotiated Rate |
$4,295.25 |
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,688.19
|
| Rate for Payer: Adventist Health Commercial |
$1,145.40
|
| Rate for Payer: Cash Price |
$2,577.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,877.18
|
| Rate for Payer: Heritage Provider Network Senior |
$3,877.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,036.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,431.75
|
| Rate for Payer: Multiplan Commercial |
$4,295.25
|
|
|
HC ESOPHAGUS CELLVIZIO
|
Facility
|
OP
|
$5,727.00
|
|
|
Service Code
|
CPT 43499
|
| Hospital Charge Code |
906743499
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,145.40
|
| Rate for Payer: Adventist Health Commercial |
$785.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,425.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,539.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,864.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,963.29
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,577.15
|
| Rate for Payer: Cash Price |
$1,766.25
|
| Rate for Payer: Cash Price |
$1,766.25
|
| Rate for Payer: Cash Price |
$2,577.15
|
| Rate for Payer: Cash Price |
$1,766.25
|
| Rate for Payer: Cash Price |
$2,577.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,551.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,722.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,545.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,429.57
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,872.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,731.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,036.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$710.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$981.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,431.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$4,295.25
|
| Rate for Payer: Multiplan Commercial |
$2,943.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
