|
HC IMMUNOGLOBULINS IGG
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910857
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.22 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Cash Price |
$97.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$120.51
|
| Rate for Payer: Heritage Provider Network Senior |
$120.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.50
|
| Rate for Payer: Multiplan Commercial |
$133.50
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$112.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$144.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.74
|
| Rate for Payer: Blue Shield of California Commercial |
$74.82
|
| Rate for Payer: Blue Shield of California EPN |
$60.01
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$136.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$129.99
|
| Rate for Payer: Heritage Provider Network Senior |
$129.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.01 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.17
|
| Rate for Payer: Heritage Provider Network Senior |
$142.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$114.75 |
| Max. Negotiated Rate |
$475.50 |
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.22
|
| Rate for Payer: Heritage Provider Network Senior |
$429.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.50
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
OP
|
$634.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.03 |
| Max. Negotiated Rate |
$475.50 |
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$338.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$435.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.03
|
| Rate for Payer: Blue Shield of California Commercial |
$200.83
|
| Rate for Payer: Blue Shield of California EPN |
$161.50
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$412.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.45
|
| Rate for Payer: Heritage Provider Network Senior |
$392.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$302.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
OP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.53 |
| Max. Negotiated Rate |
$407.15 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$256.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$329.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$263.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$405.47
|
| Rate for Payer: Blue Shield of California Commercial |
$255.94
|
| Rate for Payer: Blue Shield of California EPN |
$205.82
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$311.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$407.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.15
|
| Rate for Payer: Dignity Health Senior |
$407.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$296.50
|
| Rate for Payer: Heritage Provider Network Senior |
$296.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$98.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$228.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.30
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$66.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.15
|
| Rate for Payer: Vantage Medical Group Senior |
$407.15
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
IP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$86.70 |
| Max. Negotiated Rate |
$359.25 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$324.28
|
| Rate for Payer: Heritage Provider Network Senior |
$324.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.75
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
IP
|
$777.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$140.64 |
| Max. Negotiated Rate |
$582.75 |
| Rate for Payer: Adventist Health Commercial |
$155.40
|
| Rate for Payer: Cash Price |
$427.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$526.03
|
| Rate for Payer: Heritage Provider Network Senior |
$526.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.25
|
| Rate for Payer: Multiplan Commercial |
$582.75
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
OP
|
$777.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.92 |
| Max. Negotiated Rate |
$582.75 |
| Rate for Payer: Adventist Health Commercial |
$155.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$415.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$533.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.14
|
| Rate for Payer: Blue Shield of California Commercial |
$257.42
|
| Rate for Payer: Blue Shield of California EPN |
$207.01
|
| Rate for Payer: Cash Price |
$427.35
|
| Rate for Payer: Cash Price |
$427.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$505.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$480.96
|
| Rate for Payer: Heritage Provider Network Senior |
$480.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$91.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$370.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$582.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC IMMUNOTYPING ELECTROPHORESIS
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$252.75 |
| Rate for Payer: Adventist Health Commercial |
$67.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$180.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$231.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.93
|
| Rate for Payer: Blue Shield of California Commercial |
$179.77
|
| Rate for Payer: Blue Shield of California EPN |
$144.19
|
| Rate for Payer: Cash Price |
$185.35
|
| Rate for Payer: Cash Price |
$185.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$219.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Senior |
$22.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$219.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$22.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$208.60
|
| Rate for Payer: Heritage Provider Network Senior |
$208.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.15
|
| Rate for Payer: Multiplan Commercial |
$252.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.34
|
| Rate for Payer: TriValley Medical Group Senior |
$22.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$24.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$24.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
|
|
HC IMMUNOTYPING ELECTROPHORESIS
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.00 |
| Max. Negotiated Rate |
$252.75 |
| Rate for Payer: Adventist Health Commercial |
$67.40
|
| Rate for Payer: Cash Price |
$185.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$228.15
|
| Rate for Payer: Heritage Provider Network Senior |
$228.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.25
|
| Rate for Payer: Multiplan Commercial |
$252.75
|
|
|
HC IMPELLA LT ART VEN TRANS
|
Facility
|
OP
|
$12,136.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
906811991
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$165.26 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,337.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,674.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,102.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,888.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,315.60
|
| Rate for Payer: Dignity Health Senior |
$10,315.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,512.18
|
| Rate for Payer: Heritage Provider Network Senior |
$7,512.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$165.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,788.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,495.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,495.20
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Senior |
$10,315.60
|
|
|
HC IMPELLA LT ART VEN TRANS
|
Facility
|
IP
|
$12,136.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
906811991
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,196.62 |
| Max. Negotiated Rate |
$9,102.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,216.07
|
| Rate for Payer: Heritage Provider Network Senior |
$8,216.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
|
|
HC IMPL AGA DUCT OCCL DEVICE
|
Facility
|
OP
|
$11,408.00
|
|
|
Service Code
|
CPT C1817
|
| Hospital Charge Code |
906812240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,281.60 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$2,281.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,475.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,837.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,696.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,274.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,556.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,586.02
|
| Rate for Payer: Blue Shield of California EPN |
$4,586.02
|
| Rate for Payer: Cash Price |
$6,274.40
|
| Rate for Payer: Cash Price |
$6,274.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,247.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,696.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,696.80
|
| Rate for Payer: Dignity Health Senior |
$9,696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,301.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,281.90
|
| Rate for Payer: Heritage Provider Network Senior |
$5,281.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,704.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,704.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,704.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,852.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,985.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,985.60
|
| Rate for Payer: Multiplan Commercial |
$8,556.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,121.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,777.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,696.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,696.80
|
| Rate for Payer: Vantage Medical Group Senior |
$9,696.80
|
|
|
HC IMPL AGA DUCT OCCL DEVICE
|
Facility
|
IP
|
$11,408.00
|
|
|
Service Code
|
CPT C1817
|
| Hospital Charge Code |
906812240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,281.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$2,281.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,475.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,586.02
|
| Rate for Payer: Blue Shield of California EPN |
$4,586.02
|
| Rate for Payer: Cash Price |
$6,274.40
|
| Rate for Payer: Cash Price |
$6,274.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,247.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,160.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,281.90
|
| Rate for Payer: Heritage Provider Network Senior |
$5,281.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,704.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,704.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,704.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,852.00
|
| Rate for Payer: Multiplan Commercial |
$8,556.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,121.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,777.19
|
|
|
HC IMPLANTABLE PORT FOR MEDS
|
Facility
|
OP
|
$1,620.00
|
|
|
Service Code
|
CPT C1788
|
| Hospital Charge Code |
909081100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$777.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,112.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$891.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,215.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$651.24
|
| Rate for Payer: Blue Shield of California EPN |
$651.24
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$745.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,377.00
|
| Rate for Payer: Dignity Health Senior |
$1,377.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,036.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$750.06
|
| Rate for Payer: Heritage Provider Network Senior |
$750.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,134.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$585.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$536.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,377.00
|
|
|
HC IMPLANTABLE PORT FOR MEDS
|
Facility
|
IP
|
$1,620.00
|
|
|
Service Code
|
CPT C1788
|
| Hospital Charge Code |
909081100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$777.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$651.24
|
| Rate for Payer: Blue Shield of California EPN |
$651.24
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$745.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$750.06
|
| Rate for Payer: Heritage Provider Network Senior |
$750.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$585.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$536.38
|
|
|
HC IMPLANTED PERIONEAL PORT
|
Facility
|
OP
|
$28,856.00
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
909001457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$21,642.00 |
| Rate for Payer: Adventist Health Commercial |
$5,771.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,824.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$15,870.80
|
| Rate for Payer: Cash Price |
$15,870.80
|
| Rate for Payer: Cash Price |
$15,870.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,756.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,861.86
|
| Rate for Payer: Heritage Provider Network Senior |
$8,448.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$343.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,050.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,222.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,214.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$21,642.00
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,555.33
|
| Rate for Payer: TriValley Medical Group Senior |
$7,555.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC IMPLANTED PERIONEAL PORT
|
Facility
|
IP
|
$28,856.00
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
909001457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,222.94 |
| Max. Negotiated Rate |
$21,642.00 |
| Rate for Payer: Adventist Health Commercial |
$5,771.20
|
| Rate for Payer: Cash Price |
$15,870.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,535.51
|
| Rate for Payer: Heritage Provider Network Senior |
$19,535.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,222.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,214.00
|
| Rate for Payer: Multiplan Commercial |
$21,642.00
|
|
|
HC IMPL DRESSING WOUND 3X3.5CM OASIS ULTRA
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900104052
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.84 |
| Max. Negotiated Rate |
$61.50 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.97
|
| Rate for Payer: Heritage Provider Network Senior |
$37.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.15
|
|
|
HC IMPL DRESSING WOUND 3X3.5CM OASIS ULTRA
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900104052
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Blue Shield of California Commercial |
$50.02
|
| Rate for Payer: Blue Shield of California EPN |
$40.02
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Senior |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.97
|
| Rate for Payer: Heritage Provider Network Senior |
$37.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$39.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$32.80
|
| Rate for Payer: TriValley Medical Group Senior |
$32.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC IMPL DRESSING WOUND 3X7CM OASIS ULTRA
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900104053
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$35.65
|
| Rate for Payer: Heritage Provider Network Senior |
$35.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.49
|
|
|
HC IMPL DRESSING WOUND 3X7CM OASIS ULTRA
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900104053
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$65.45 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$65.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.75
|
| Rate for Payer: Blue Shield of California Commercial |
$46.97
|
| Rate for Payer: Blue Shield of California EPN |
$37.58
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$65.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$65.45
|
| Rate for Payer: Dignity Health Senior |
$65.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$35.65
|
| Rate for Payer: Heritage Provider Network Senior |
$35.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.90
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$30.80
|
| Rate for Payer: TriValley Medical Group Senior |
$30.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$65.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.45
|
| Rate for Payer: Vantage Medical Group Senior |
$65.45
|
|
|
HC IMPL DRESSING WOUND 5X7CM OASIS ULTRA
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900101468
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.50
|
| Rate for Payer: Blue Shield of California Commercial |
$54.90
|
| Rate for Payer: Blue Shield of California EPN |
$43.92
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$76.50
|
| Rate for Payer: Dignity Health Senior |
$76.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.67
|
| Rate for Payer: Heritage Provider Network Senior |
$41.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$42.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$32.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.50
|
| Rate for Payer: Vantage Medical Group Senior |
$76.50
|
|
|
HC IMPL DRESSING WOUND 5X7CM OASIS ULTRA
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT Q4124
|
| Hospital Charge Code |
900101468
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.67
|
| Rate for Payer: Heritage Provider Network Senior |
$41.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$32.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.80
|
|
