|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
OP
|
$5,215.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,043.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,582.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,868.25
|
| Rate for Payer: Cash Price |
$2,868.25
|
| Rate for Payer: Cash Price |
$2,868.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,389.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,530.55
|
| Rate for Payer: Heritage Provider Network Senior |
$3,530.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,487.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,303.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$3,911.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,876.36
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,726.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$816.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,802.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,652.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Senior |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,498.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,762.16
|
| Rate for Payer: Heritage Provider Network Senior |
$2,762.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,946.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$738.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,722.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,887.66
|
| Rate for Payer: Multiplan Commercial |
$3,060.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,467.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,350.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$738.48 |
| Max. Negotiated Rate |
$3,060.00 |
| Rate for Payer: Adventist Health Commercial |
$816.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,762.16
|
| Rate for Payer: Heritage Provider Network Senior |
$2,762.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$738.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.00
|
| Rate for Payer: Multiplan Commercial |
$3,060.00
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$5,007.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$906.27 |
| Max. Negotiated Rate |
$3,755.25 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,389.74
|
| Rate for Payer: Heritage Provider Network Senior |
$3,389.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$5,007.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,439.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,254.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Senior |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,636.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,389.74
|
| Rate for Payer: Heritage Provider Network Senior |
$3,389.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,388.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,182.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,582.02
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,801.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,657.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$5,007.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$906.27 |
| Max. Negotiated Rate |
$3,755.25 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,389.74
|
| Rate for Payer: Heritage Provider Network Senior |
$3,389.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$5,007.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,439.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,254.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Senior |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,636.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,099.33
|
| Rate for Payer: Heritage Provider Network Senior |
$4,472.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$113.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,909.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,182.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,582.02
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,000.17
|
| Rate for Payer: TriValley Medical Group Senior |
$4,000.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
IP
|
$5,007.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$906.27 |
| Max. Negotiated Rate |
$3,755.25 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,389.74
|
| Rate for Payer: Heritage Provider Network Senior |
$3,389.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
OP
|
$5,007.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,001.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,439.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cash Price |
$2,753.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,254.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Senior |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,636.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,389.74
|
| Rate for Payer: Heritage Provider Network Senior |
$3,389.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,388.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$906.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,182.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,251.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,582.02
|
| Rate for Payer: Multiplan Commercial |
$3,755.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,801.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,657.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION FINGER TENDON EACH
|
Facility
|
OP
|
$3,990.00
|
|
|
Service Code
|
CPT 26455
|
| Hospital Charge Code |
900501536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,741.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,903.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,435.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,321.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC INCISION FINGER TENDON EACH
|
Facility
|
IP
|
$3,990.00
|
|
|
Service Code
|
CPT 26455
|
| Hospital Charge Code |
900501536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.19 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
|
|
HC INCISION LINGUAL FRENUM
|
Facility
|
IP
|
$3,673.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
900501558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$664.81 |
| Max. Negotiated Rate |
$2,754.75 |
| Rate for Payer: Adventist Health Commercial |
$734.60
|
| Rate for Payer: Cash Price |
$2,020.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,486.62
|
| Rate for Payer: Heritage Provider Network Senior |
$2,486.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$918.25
|
| Rate for Payer: Multiplan Commercial |
$2,754.75
|
|
|
HC INCISION LINGUAL FRENUM
|
Facility
|
OP
|
$3,673.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
900501558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$734.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,523.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,020.15
|
| Rate for Payer: Cash Price |
$2,020.15
|
| Rate for Payer: Cash Price |
$2,020.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,387.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Senior |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,882.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,486.62
|
| Rate for Payer: Heritage Provider Network Senior |
$2,486.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,752.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,164.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$918.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,371.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,371.46
|
| Rate for Payer: Multiplan Commercial |
$2,754.75
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,321.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,216.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC INCISION OF EYE
|
Facility
|
OP
|
$6,458.00
|
|
|
Service Code
|
CPT 66172
|
| Hospital Charge Code |
900501631
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,111.00 |
| Rate for Payer: Adventist Health Commercial |
$1,291.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,436.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$3,551.90
|
| Rate for Payer: Cash Price |
$3,551.90
|
| Rate for Payer: Cash Price |
$3,551.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,197.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Senior |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,197.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,897.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,372.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,372.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,080.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,168.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,332.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,651.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,651.35
|
| Rate for Payer: Multiplan Commercial |
$4,843.50
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,323.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,138.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC INCISION OF EYE
|
Facility
|
IP
|
$6,458.00
|
|
|
Service Code
|
CPT 66172
|
| Hospital Charge Code |
900501631
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,168.90 |
| Max. Negotiated Rate |
$4,843.50 |
| Rate for Payer: Adventist Health Commercial |
$1,291.60
|
| Rate for Payer: Cash Price |
$3,551.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,372.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,372.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,168.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.50
|
| Rate for Payer: Multiplan Commercial |
$4,843.50
|
|
|
HC INCISION OF LABIAL FRENUM
|
Facility
|
OP
|
$742.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
900501559
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$148.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$509.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$482.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Senior |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$647.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$502.33
|
| Rate for Payer: Heritage Provider Network Senior |
$502.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$353.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$744.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.28
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$266.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$245.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
HC INCISION OF LABIAL FRENUM
|
Facility
|
IP
|
$742.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
900501559
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.30 |
| Max. Negotiated Rate |
$556.50 |
| Rate for Payer: Adventist Health Commercial |
$148.40
|
| Rate for Payer: Cash Price |
$408.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$502.33
|
| Rate for Payer: Heritage Provider Network Senior |
$502.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.50
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$1,201.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$825.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$732.61
|
| Rate for Payer: Blue Shield of California EPN |
$586.09
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$780.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Senior |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$309.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$743.42
|
| Rate for Payer: Heritage Provider Network Senior |
$743.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$309.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$572.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$355.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.37
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$339.92
|
| Rate for Payer: TriValley Medical Group Senior |
$309.02
|
| 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 |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$1,201.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$900.75 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$1,201.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$825.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$780.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Senior |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$309.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$572.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$355.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.37
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$432.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$397.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$1,201.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$900.75 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
|
|
HC INC & REM F/B SUBQ TIS COMPL
|
Facility
|
IP
|
$4,402.00
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
900501004
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$796.76 |
| Max. Negotiated Rate |
$3,301.50 |
| Rate for Payer: Adventist Health Commercial |
$880.40
|
| Rate for Payer: Cash Price |
$2,421.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,980.15
|
| Rate for Payer: Heritage Provider Network Senior |
$2,980.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$796.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.50
|
| Rate for Payer: Multiplan Commercial |
$3,301.50
|
|
|
HC INC & REM F/B SUBQ TIS COMPL
|
Facility
|
OP
|
$4,402.00
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
900501004
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$880.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,024.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,421.10
|
| Rate for Payer: Cash Price |
$2,421.10
|
| Rate for Payer: Cash Price |
$2,421.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,861.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,980.15
|
| Rate for Payer: Heritage Provider Network Senior |
$2,980.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,099.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$796.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,100.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$3,301.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,583.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,457.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
IP
|
$1,201.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$900.75 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
OP
|
$1,201.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$825.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$780.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Senior |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$507.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$572.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$639.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$639.63
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$432.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$397.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
