|
HC I-123 CAPSULES PER 100-999 UCI
|
Facility
|
OP
|
$370.00
|
|
|
Service Code
|
CPT A9516
|
| Hospital Charge Code |
909301511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$314.50 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.50
|
| Rate for Payer: Blue Shield of California Commercial |
$225.70
|
| Rate for Payer: Blue Shield of California EPN |
$180.56
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.50
|
| Rate for Payer: Dignity Health Senior |
$314.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$144.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$176.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$259.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$259.00
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$148.00
|
| Rate for Payer: TriValley Medical Group Senior |
$148.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.50
|
| Rate for Payer: Vantage Medical Group Senior |
$314.50
|
|
|
HC I-123 CAPSULES PER 100-999 UCI
|
Facility
|
IP
|
$370.00
|
|
|
Service Code
|
CPT A9516
|
| Hospital Charge Code |
909301511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
|
|
HC I123 IOFLUPANE, UP TO 5MCI
|
Facility
|
IP
|
$1,966.00
|
|
|
Service Code
|
CPT A9584
|
| Hospital Charge Code |
909301512
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$355.85 |
| Max. Negotiated Rate |
$1,474.50 |
| Rate for Payer: Adventist Health Commercial |
$393.20
|
| Rate for Payer: Cash Price |
$1,081.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,061.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,330.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,330.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$491.50
|
| Rate for Payer: Multiplan Commercial |
$1,474.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$710.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$650.94
|
|
|
HC I123 IOFLUPANE, UP TO 5MCI
|
Facility
|
OP
|
$1,966.00
|
|
|
Service Code
|
CPT A9584
|
| Hospital Charge Code |
909301512
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$355.85 |
| Max. Negotiated Rate |
$1,748.91 |
| Rate for Payer: Adventist Health Commercial |
$393.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,735.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,526.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,526.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,199.26
|
| Rate for Payer: Blue Shield of California EPN |
$959.41
|
| Rate for Payer: Cash Price |
$1,081.30
|
| Rate for Payer: Cash Price |
$1,081.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,277.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,735.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,526.82
|
| Rate for Payer: Dignity Health Senior |
$1,526.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,258.24
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,388.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,216.95
|
| Rate for Payer: Heritage Provider Network Senior |
$1,216.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,388.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$937.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,596.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$491.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,748.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,748.91
|
| Rate for Payer: Multiplan Commercial |
$1,474.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,526.82
|
| Rate for Payer: TriValley Medical Group Senior |
$1,388.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$710.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$650.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,735.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,526.82
|
| Rate for Payer: Vantage Medical Group Senior |
$1,526.82
|
|
|
HC I-125 SEED
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT A4648
|
| Hospital Charge Code |
909301514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$126.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$105.73
|
| Rate for Payer: Blue Shield of California EPN |
$105.73
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.77
|
| Rate for Payer: Heritage Provider Network Senior |
$121.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.75
|
| Rate for Payer: Multiplan Commercial |
$197.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$95.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$87.08
|
|
|
HC I-125 SEED
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT A4648
|
| Hospital Charge Code |
909301514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$126.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$180.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$144.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$197.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$105.73
|
| Rate for Payer: Blue Shield of California EPN |
$105.73
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$223.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$223.55
|
| Rate for Payer: Dignity Health Senior |
$223.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.77
|
| Rate for Payer: Heritage Provider Network Senior |
$121.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.10
|
| Rate for Payer: Multiplan Commercial |
$197.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$95.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$87.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$223.55
|
| Rate for Payer: Vantage Medical Group Senior |
$223.55
|
|
|
HC I-125 SERUM ALBUMIN PER 5 UCI
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT A9532
|
| Hospital Charge Code |
909301517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.28 |
| Max. Negotiated Rate |
$372.30 |
| Rate for Payer: Adventist Health Commercial |
$87.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$372.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$240.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$328.50
|
| Rate for Payer: Blue Shield of California Commercial |
$267.18
|
| Rate for Payer: Blue Shield of California EPN |
$213.74
|
| Rate for Payer: Cash Price |
$240.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$201.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$372.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$372.30
|
| Rate for Payer: Dignity Health Senior |
$372.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.79
|
| Rate for Payer: Heritage Provider Network Senior |
$202.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$208.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$306.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$306.60
|
| Rate for Payer: Multiplan Commercial |
$328.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.20
|
| Rate for Payer: TriValley Medical Group Senior |
$175.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$145.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$372.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$372.30
|
| Rate for Payer: Vantage Medical Group Senior |
$372.30
|
|
|
HC I-125 SERUM ALBUMIN PER 5 UCI
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT A9532
|
| Hospital Charge Code |
909301517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.28 |
| Max. Negotiated Rate |
$328.50 |
| Rate for Payer: Adventist Health Commercial |
$87.60
|
| Rate for Payer: Cash Price |
$240.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$201.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.79
|
| Rate for Payer: Heritage Provider Network Senior |
$202.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.50
|
| Rate for Payer: Multiplan Commercial |
$328.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$145.02
|
|
|
HC I-131 IOBENGUANE/MIBG PER.5MCI
|
Facility
|
OP
|
$5,753.00
|
|
|
Service Code
|
CPT A9508
|
| Hospital Charge Code |
909301519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$746.76 |
| Max. Negotiated Rate |
$4,890.05 |
| Rate for Payer: Adventist Health Commercial |
$1,150.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,890.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,164.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,314.75
|
| Rate for Payer: Blue Shield of California Commercial |
$3,509.33
|
| Rate for Payer: Blue Shield of California EPN |
$2,807.46
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,890.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,890.05
|
| Rate for Payer: Dignity Health Senior |
$4,890.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,681.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,663.64
|
| Rate for Payer: Heritage Provider Network Senior |
$2,663.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$746.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,744.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,041.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,027.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,027.10
|
| Rate for Payer: Multiplan Commercial |
$4,314.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,301.20
|
| Rate for Payer: TriValley Medical Group Senior |
$2,301.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,078.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,904.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,890.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,890.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,890.05
|
|
|
HC I-131 IOBENGUANE/MIBG PER.5MCI
|
Facility
|
IP
|
$5,753.00
|
|
|
Service Code
|
CPT A9508
|
| Hospital Charge Code |
909301519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,041.29 |
| Max. Negotiated Rate |
$4,314.75 |
| Rate for Payer: Adventist Health Commercial |
$1,150.60
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,106.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,663.64
|
| Rate for Payer: Heritage Provider Network Senior |
$2,663.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,041.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.25
|
| Rate for Payer: Multiplan Commercial |
$4,314.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,078.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,904.82
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI DX
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT A9529
|
| Hospital Charge Code |
909309529
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$83.08 |
| Max. Negotiated Rate |
$390.15 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$344.25
|
| Rate for Payer: Blue Shield of California Commercial |
$279.99
|
| Rate for Payer: Blue Shield of California EPN |
$223.99
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$298.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.15
|
| Rate for Payer: Dignity Health Senior |
$390.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$284.12
|
| Rate for Payer: Heritage Provider Network Senior |
$284.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$218.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$321.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$321.30
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$165.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.15
|
| Rate for Payer: Vantage Medical Group Senior |
$390.15
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI DX
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT A9529
|
| Hospital Charge Code |
909309529
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$83.08 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$310.74
|
| Rate for Payer: Heritage Provider Network Senior |
$310.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.75
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$165.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.97
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI TH
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT A9530
|
| Hospital Charge Code |
909301569
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$20.88 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$115.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.97
|
| Rate for Payer: Blue Shield of California Commercial |
$132.37
|
| Rate for Payer: Blue Shield of California EPN |
$105.90
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$141.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.97
|
| Rate for Payer: Dignity Health Senior |
$22.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$134.32
|
| Rate for Payer: Heritage Provider Network Senior |
$134.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$103.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.31
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.97
|
| Rate for Payer: TriValley Medical Group Senior |
$20.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$78.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.97
|
| Rate for Payer: Vantage Medical Group Senior |
$22.97
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI TH
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT A9530
|
| Hospital Charge Code |
909301569
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$146.91
|
| Rate for Payer: Heritage Provider Network Senior |
$146.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.25
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$78.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.85
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
IP
|
$7,408.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,340.85 |
| Max. Negotiated Rate |
$5,556.00 |
| Rate for Payer: Adventist Health Commercial |
$1,481.60
|
| Rate for Payer: Cash Price |
$4,074.40
|
| Rate for Payer: Cash Price |
$4,074.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,340.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.00
|
| Rate for Payer: Multiplan Commercial |
$5,556.00
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
IP
|
$8,715.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906820051
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,577.41 |
| Max. Negotiated Rate |
$6,536.25 |
| Rate for Payer: Adventist Health Commercial |
$1,743.00
|
| Rate for Payer: Cash Price |
$4,793.25
|
| Rate for Payer: Cash Price |
$4,793.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,577.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,178.75
|
| Rate for Payer: Multiplan Commercial |
$6,536.25
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
OP
|
$7,408.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,481.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,089.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,296.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,074.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,556.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$4,074.40
|
| Rate for Payer: Cash Price |
$4,074.40
|
| Rate for Payer: Cash Price |
$4,074.40
|
| Rate for Payer: Cash Price |
$4,074.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,815.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,296.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,296.80
|
| Rate for Payer: Dignity Health Senior |
$6,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,815.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,585.55
|
| Rate for Payer: Heritage Provider Network Senior |
$4,585.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$879.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,533.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,340.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,185.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,185.60
|
| Rate for Payer: Multiplan Commercial |
$5,556.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,296.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,296.80
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
OP
|
$8,715.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906820051
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,743.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,987.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,793.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,536.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$4,793.25
|
| Rate for Payer: Cash Price |
$4,793.25
|
| Rate for Payer: Cash Price |
$4,793.25
|
| Rate for Payer: Cash Price |
$4,793.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,664.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,407.75
|
| Rate for Payer: Dignity Health Senior |
$7,407.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,664.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,394.59
|
| Rate for Payer: Heritage Provider Network Senior |
$5,394.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$879.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,157.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,577.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,178.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,100.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,100.50
|
| Rate for Payer: Multiplan Commercial |
$6,536.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,407.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,407.75
|
| Rate for Payer: Vantage Medical Group Senior |
$7,407.75
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
IP
|
$5,956.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906820107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,078.04 |
| Max. Negotiated Rate |
$4,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.20
|
| Rate for Payer: Cash Price |
$3,275.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,032.21
|
| Rate for Payer: Heritage Provider Network Senior |
$4,032.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,078.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.00
|
| Rate for Payer: Multiplan Commercial |
$4,467.00
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
IP
|
$4,087.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$739.75 |
| Max. Negotiated Rate |
$3,065.25 |
| Rate for Payer: Adventist Health Commercial |
$817.40
|
| Rate for Payer: Cash Price |
$2,247.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,766.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,766.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.75
|
| Rate for Payer: Multiplan Commercial |
$3,065.25
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
OP
|
$4,087.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$739.75 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$817.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,807.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,247.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,065.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$2,247.85
|
| Rate for Payer: Cash Price |
$2,247.85
|
| Rate for Payer: Cash Price |
$2,247.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,656.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,473.95
|
| Rate for Payer: Dignity Health Senior |
$3,473.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,529.85
|
| Rate for Payer: Heritage Provider Network Senior |
$2,529.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,451.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,949.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,860.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,860.90
|
| Rate for Payer: Multiplan Commercial |
$3,065.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10,259.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,473.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,473.95
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
OP
|
$5,956.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906820107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,078.04 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,091.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,275.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,467.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$3,275.80
|
| Rate for Payer: Cash Price |
$3,275.80
|
| Rate for Payer: Cash Price |
$3,275.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,871.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,062.60
|
| Rate for Payer: Dignity Health Senior |
$5,062.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,686.76
|
| Rate for Payer: Heritage Provider Network Senior |
$3,686.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,451.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,841.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,078.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,489.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,169.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,169.20
|
| Rate for Payer: Multiplan Commercial |
$4,467.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10,259.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,062.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,062.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,062.60
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,304.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,126.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,977.39
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$243.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$870.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$3,607.50 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,256.37
|
| Rate for Payer: Heritage Provider Network Senior |
$3,256.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$870.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906820122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,887.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,678.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,502.92
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$243.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,024.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,414.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
