|
HC GASTROSTOMY TUBE PERCUT
|
Facility
IP
|
$2,706.00
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
906743750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$489.79 |
| Max. Negotiated Rate |
$2,029.50 |
| Rate for Payer: Adventist Health Commercial |
$541.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,859.02
|
| Rate for Payer: Cash Price |
$1,217.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,831.96
|
| Rate for Payer: Heritage Provider Network Senior |
$1,831.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$489.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$676.50
|
| Rate for Payer: Multiplan Commercial |
$2,029.50
|
|
|
HC GASTROSTOMY TUBE PERCUT
|
Facility
OP
|
$2,547.00
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
906743750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$509.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,749.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,655.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: Dignity Health Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,377.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,576.59
|
| Rate for Payer: Heritage Provider Network Senior |
$2,924.26
|
| Rate for Payer: Humana Medicare |
$2,377.45
|
| Rate for Payer: IEHP Medi-Cal |
$1,436.29
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,517.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,805.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,995.59
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| 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 |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC GASTROSTOMY TUBE REPOSITION
|
Facility
OP
|
$3,076.00
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
906743761
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$123.71 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$615.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,113.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$308.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,910.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,805.61
|
| Rate for Payer: Cash Price |
$1,384.20
|
| Rate for Payer: Cash Price |
$1,384.20
|
| Rate for Payer: Cash Price |
$1,384.20
|
| Rate for Payer: Cash Price |
$1,384.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,999.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: Dignity Health Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$308.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,904.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,904.04
|
| Rate for Payer: Humana Medicare |
$308.79
|
| Rate for Payer: IEHP Medi-Cal |
$123.71
|
| Rate for Payer: IEHP Medicare Advantage |
$308.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$586.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$556.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$364.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$769.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.08
|
| Rate for Payer: Multiplan Commercial |
$2,307.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$339.67
|
| Rate for Payer: TriValley Medical Group Senior |
$308.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$501.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$422.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC GASTROSTOMY TUBE REPOSITION
|
Facility
IP
|
$3,076.00
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
906743761
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$556.76 |
| Max. Negotiated Rate |
$2,307.00 |
| Rate for Payer: Adventist Health Commercial |
$615.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,113.21
|
| Rate for Payer: Cash Price |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,082.45
|
| Rate for Payer: Heritage Provider Network Senior |
$2,082.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$556.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$769.00
|
| Rate for Payer: Multiplan Commercial |
$2,307.00
|
|
|
HC GASTRO TUBE PLACEMENT
|
Facility
OP
|
$1,928.00
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
906744500
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$30.20 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$51.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,197.29
|
| Rate for Payer: Blue Shield of California EPN |
$1,131.74
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,253.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: Dignity Health Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,132.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,193.43
|
| Rate for Payer: Heritage Provider Network Senior |
$1,193.43
|
| Rate for Payer: Humana Medicare |
$1,132.59
|
| Rate for Payer: IEHP Medi-Cal |
$30.20
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,151.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,336.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,427.06
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,245.85
|
| Rate for Payer: TriValley Medical Group Senior |
$1,132.59
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$501.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$422.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC GASTRO TUBE PLACEMENT
|
Facility
IP
|
$1,928.00
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
906744500
|
|
Hospital Revenue Code
|
949
|
| Min. Negotiated Rate |
$348.97 |
| Max. Negotiated Rate |
$1,446.00 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,305.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,305.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
|
|
HC GASTRO TUBE REMOVAL
|
Facility
OP
|
$4,245.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
900100022
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$849.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,916.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,910.25
|
| Rate for Payer: Cash Price |
$1,910.25
|
| Rate for Payer: Cash Price |
$1,910.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,759.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: Dignity Health Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,132.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,627.66
|
| Rate for Payer: Heritage Provider Network Senior |
$1,393.09
|
| Rate for Payer: Humana Medicare |
$1,132.59
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,151.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$768.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,336.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,427.06
|
| Rate for Payer: Multiplan Commercial |
$3,183.75
|
| 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 |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC GASTRO TUBE REMOVAL
|
Facility
IP
|
$8,010.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
900100022
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,449.81 |
| Max. Negotiated Rate |
$6,007.50 |
| Rate for Payer: Adventist Health Commercial |
$1,602.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,502.87
|
| Rate for Payer: Cash Price |
$3,604.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,422.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5,422.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,449.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,002.50
|
| Rate for Payer: Multiplan Commercial |
$6,007.50
|
|
|
HC GASTRO UGI SNGL CNTRST
|
Facility
OP
|
$926.00
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
909001873
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.33 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Adventist Health Commercial |
$185.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$173.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$636.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.01
|
| Rate for Payer: Blue Shield of California Commercial |
$297.54
|
| Rate for Payer: Blue Shield of California EPN |
$169.20
|
| Rate for Payer: Cash Price |
$416.70
|
| Rate for Payer: Cash Price |
$416.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$601.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: Dignity Health Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$601.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$229.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$573.19
|
| Rate for Payer: Heritage Provider Network Senior |
$573.19
|
| Rate for Payer: Humana Medicare |
$229.56
|
| Rate for Payer: IEHP Medi-Cal |
$159.17
|
| Rate for Payer: IEHP Medicare Advantage |
$229.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$436.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$270.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.25
|
| Rate for Payer: Multiplan Commercial |
$694.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$229.56
|
| Rate for Payer: TriValley Medical Group Senior |
$229.56
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$137.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC GASTRO UGI SNGL CNTRST
|
Facility
IP
|
$926.00
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
909001873
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$167.61 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Adventist Health Commercial |
$185.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$636.16
|
| Rate for Payer: Cash Price |
$416.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$626.90
|
| Rate for Payer: Heritage Provider Network Senior |
$626.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.50
|
| Rate for Payer: Multiplan Commercial |
$694.50
|
|
|
HC GASTROVIEW PER ML
|
Facility
OP
|
$1.00
|
|
|
Service Code
|
CPT Q9960
|
| Hospital Charge Code |
909001017
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Blue Shield of California Commercial |
$0.62
|
| Rate for Payer: Blue Shield of California EPN |
$0.59
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.85
|
| Rate for Payer: Dignity Health Senior |
$0.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.62
|
| Rate for Payer: Heritage Provider Network Senior |
$0.62
|
| Rate for Payer: IEHP Medi-Cal |
$0.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$0.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Senior |
$75.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.85
|
| Rate for Payer: Vantage Medical Group Senior |
$0.85
|
|
|
HC GASTROVIEW PER ML
|
Facility
IP
|
$1.00
|
|
|
Service Code
|
CPT Q9960
|
| Hospital Charge Code |
909001017
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.69
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.68
|
| Rate for Payer: Heritage Provider Network Senior |
$0.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$0.75
|
|
|
HC GATED BLOOD POOL- MUGA
|
Facility
OP
|
$2,371.00
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
909301381
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$261.72 |
| Max. Negotiated Rate |
$1,778.25 |
| Rate for Payer: Adventist Health Commercial |
$474.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$450.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,628.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,126.56
|
| Rate for Payer: Blue Shield of California EPN |
$640.64
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,541.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: Dignity Health Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$515.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,467.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,467.65
|
| Rate for Payer: Humana Medicare |
$515.32
|
| Rate for Payer: IEHP Medi-Cal |
$261.72
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$979.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$608.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$592.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$649.30
|
| Rate for Payer: Multiplan Commercial |
$1,778.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$566.85
|
| Rate for Payer: TriValley Medical Group Senior |
$515.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC GATED BLOOD POOL- MUGA
|
Facility
IP
|
$2,371.00
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
909301381
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$429.15 |
| Max. Negotiated Rate |
$1,778.25 |
| Rate for Payer: Adventist Health Commercial |
$474.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,628.88
|
| Rate for Payer: Cash Price |
$1,066.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,605.17
|
| Rate for Payer: Heritage Provider Network Senior |
$1,605.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$592.75
|
| Rate for Payer: Multiplan Commercial |
$1,778.25
|
|
|
HC GATED FIRST PASS
|
Facility
OP
|
$2,213.00
|
|
|
Service Code
|
CPT 78481
|
| Hospital Charge Code |
909301391
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$246.53 |
| Max. Negotiated Rate |
$1,659.75 |
| Rate for Payer: Adventist Health Commercial |
$442.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$355.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,520.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,066.86
|
| Rate for Payer: Blue Shield of California EPN |
$606.69
|
| Rate for Payer: Cash Price |
$995.85
|
| Rate for Payer: Cash Price |
$995.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,438.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.86
|
| Rate for Payer: Dignity Health Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,438.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$675.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,369.85
|
| Rate for Payer: Heritage Provider Network Senior |
$1,369.85
|
| Rate for Payer: Humana Medicare |
$675.33
|
| Rate for Payer: IEHP Medi-Cal |
$246.53
|
| Rate for Payer: IEHP Medicare Advantage |
$675.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,283.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$553.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$850.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$850.92
|
| Rate for Payer: Multiplan Commercial |
$1,659.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$742.86
|
| Rate for Payer: TriValley Medical Group Senior |
$675.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC GATED FIRST PASS
|
Facility
IP
|
$2,213.00
|
|
|
Service Code
|
CPT 78481
|
| Hospital Charge Code |
909301391
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$400.55 |
| Max. Negotiated Rate |
$1,659.75 |
| Rate for Payer: Adventist Health Commercial |
$442.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,520.33
|
| Rate for Payer: Cash Price |
$995.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,498.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,498.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$553.25
|
| Rate for Payer: Multiplan Commercial |
$1,659.75
|
|
|
HC GB GALLBLADDER
|
Facility
IP
|
$455.00
|
|
|
Service Code
|
CPT 74290
|
| Hospital Charge Code |
909001818
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$82.36 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$312.58
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$308.04
|
| Rate for Payer: Heritage Provider Network Senior |
$308.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
|
|
HC GB GALLBLADDER
|
Facility
OP
|
$455.00
|
|
|
Service Code
|
CPT 74290
|
| Hospital Charge Code |
909001818
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.95 |
| Max. Negotiated Rate |
$436.16 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$117.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$312.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$177.56
|
| Rate for Payer: Blue Shield of California Commercial |
$152.15
|
| Rate for Payer: Blue Shield of California EPN |
$86.52
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$295.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: Dignity Health Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$229.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$281.64
|
| Rate for Payer: Heritage Provider Network Senior |
$281.64
|
| Rate for Payer: Humana Medicare |
$229.56
|
| Rate for Payer: IEHP Medi-Cal |
$59.95
|
| Rate for Payer: IEHP Medicare Advantage |
$229.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$436.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$270.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.25
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$229.56
|
| Rate for Payer: TriValley Medical Group Senior |
$229.56
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$137.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC GDC 2-DIAMETER
|
Facility
IP
|
$1,764.00
|
|
| Hospital Charge Code |
909081817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.80 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$352.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$846.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,211.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$811.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$952.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,194.23
|
| Rate for Payer: Heritage Provider Network Senior |
$1,194.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$882.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$882.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$882.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$1,323.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$643.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$589.35
|
|
|
HC GDC 2-DIAMETER
|
Facility
OP
|
$1,764.00
|
|
| Hospital Charge Code |
909081817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.80 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$352.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$846.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,211.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,499.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$970.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,323.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,095.44
|
| Rate for Payer: Blue Shield of California EPN |
$1,035.47
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$811.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,499.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,499.40
|
| Rate for Payer: Dignity Health Senior |
$1,499.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,128.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$816.73
|
| Rate for Payer: Heritage Provider Network Senior |
$816.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$882.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$882.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$882.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$1,323.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$643.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$589.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,499.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,499.40
|
|
|
HC GDC 3-D SHAPE
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909081818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,872.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,679.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,794.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,106.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,640.30
|
| Rate for Payer: Heritage Provider Network Senior |
$2,640.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,950.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,421.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,302.99
|
|
|
HC GDC 3-D SHAPE
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909081818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,872.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,679.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,421.90
|
| Rate for Payer: Blue Shield of California EPN |
$2,289.30
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,794.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Senior |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,805.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,805.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,950.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,421.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,302.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC GDC SOFT
|
Facility
OP
|
$1,530.00
|
|
| Hospital Charge Code |
909081814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$734.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,051.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,300.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$841.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,147.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$950.13
|
| Rate for Payer: Blue Shield of California EPN |
$898.11
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$703.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,300.50
|
| Rate for Payer: Dignity Health Senior |
$1,300.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$979.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$708.39
|
| Rate for Payer: Heritage Provider Network Senior |
$708.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$765.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$765.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$557.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$511.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,300.50
|
|
|
HC GDC SOFT
|
Facility
IP
|
$1,530.00
|
|
| Hospital Charge Code |
909081814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$734.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,051.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$703.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$826.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,035.81
|
| Rate for Payer: Heritage Provider Network Senior |
$1,035.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$765.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$765.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$557.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$511.17
|
|
|
HC GDC STANDARD
|
Facility
IP
|
$4,347.50
|
|
| Hospital Charge Code |
909081815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$869.50 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$869.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,086.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,986.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$1,956.38
|
| Rate for Payer: Cash Price |
$1,956.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,999.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,347.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,943.26
|
| Rate for Payer: Heritage Provider Network Senior |
$2,943.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,173.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,173.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,173.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,086.88
|
| Rate for Payer: Multiplan Commercial |
$3,260.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,585.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,452.50
|
|
