|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
OP
|
$868.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.11 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$173.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$596.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$564.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: Dignity Health Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$392.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$587.64
|
| Rate for Payer: Heritage Provider Network Senior |
$587.64
|
| Rate for Payer: Humana Medicare |
$392.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$418.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$462.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$217.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$494.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$494.13
|
| Rate for Payer: Multiplan Commercial |
$651.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$315.17
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
IP
|
$868.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.11 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: Adventist Health Commercial |
$173.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$596.32
|
| Rate for Payer: Cash Price |
$390.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$587.64
|
| Rate for Payer: Heritage Provider Network Senior |
$587.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$217.00
|
| Rate for Payer: Multiplan Commercial |
$651.00
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$108.60 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Adventist Health Commercial |
$120.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$412.20
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$406.20
|
| Rate for Payer: Heritage Provider Network Senior |
$406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Multiplan Commercial |
$450.00
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.42 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Adventist Health Commercial |
$120.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$146.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$412.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$312.02
|
| Rate for Payer: Blue Shield of California Commercial |
$266.69
|
| Rate for Payer: Blue Shield of California EPN |
$151.66
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$390.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: Dignity Health Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$371.40
|
| Rate for Payer: Heritage Provider Network Senior |
$371.40
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$59.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143.06
|
| Rate for Payer: Multiplan Commercial |
$450.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$113.54
|
| Rate for Payer: TriValley Medical Group Senior |
$113.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$141.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$141.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$367.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: Dignity Health Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$367.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$247.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$382.50
|
| Rate for Payer: Heritage Provider Network Senior |
$382.50
|
| Rate for Payer: Humana Medicare |
$247.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$272.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.84
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$205.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$188.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$423.75 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$382.50
|
| Rate for Payer: Heritage Provider Network Senior |
$382.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$423.75 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$382.50
|
| Rate for Payer: Heritage Provider Network Senior |
$382.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$367.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: Dignity Health Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$367.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$247.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$349.74
|
| Rate for Payer: Heritage Provider Network Senior |
$349.74
|
| Rate for Payer: Humana Medicare |
$247.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$65.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$470.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.84
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$423.75 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$382.50
|
| Rate for Payer: Heritage Provider Network Senior |
$382.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$113.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cash Price |
$254.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$367.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: Dignity Health Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$367.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$247.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$349.74
|
| Rate for Payer: Heritage Provider Network Senior |
$349.74
|
| Rate for Payer: Humana Medicare |
$247.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$65.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$470.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.84
|
| Rate for Payer: Multiplan Commercial |
$423.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
IP
|
$273.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$187.55
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$184.82
|
| Rate for Payer: Heritage Provider Network Senior |
$184.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.25
|
| Rate for Payer: Multiplan Commercial |
$204.75
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
OP
|
$273.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$187.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$266.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$169.53
|
| Rate for Payer: Blue Shield of California EPN |
$160.25
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$177.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$399.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$293.14
|
| Rate for Payer: Dignity Health Senior |
$266.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$266.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$168.99
|
| Rate for Payer: Heritage Provider Network Senior |
$168.99
|
| Rate for Payer: Humana Medicare |
$266.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$78.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$266.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$506.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$314.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.78
|
| Rate for Payer: Multiplan Commercial |
$204.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$293.14
|
| Rate for Payer: TriValley Medical Group Senior |
$266.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Vantage Medical Group Senior |
$266.49
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.74 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$129.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$419.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: Dignity Health Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$370.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$436.66
|
| Rate for Payer: Heritage Provider Network Senior |
$436.66
|
| Rate for Payer: Humana Medicare |
$370.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$310.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$436.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.28
|
| Rate for Payer: Multiplan Commercial |
$483.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$234.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$215.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.74 |
| Max. Negotiated Rate |
$483.75 |
| Rate for Payer: Adventist Health Commercial |
$129.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.12
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$436.66
|
| Rate for Payer: Heritage Provider Network Senior |
$436.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.25
|
| Rate for Payer: Multiplan Commercial |
$483.75
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
OP
|
$951.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$172.13 |
| Max. Negotiated Rate |
$979.11 |
| Rate for Payer: Adventist Health Commercial |
$190.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$328.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$653.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Blue Shield of California Commercial |
$382.17
|
| Rate for Payer: Blue Shield of California EPN |
$217.33
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$618.15
|
| 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 |
$618.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$515.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$588.67
|
| Rate for Payer: Heritage Provider Network Senior |
$588.67
|
| Rate for Payer: Humana Medicare |
$515.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$188.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$979.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$608.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.75
|
| 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 |
$713.25
|
| 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 N-CARDIAC VASC FLOW IMAG
|
Facility
|
IP
|
$951.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$172.13 |
| Max. Negotiated Rate |
$713.25 |
| Rate for Payer: Adventist Health Commercial |
$190.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$653.34
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$643.83
|
| Rate for Payer: Heritage Provider Network Senior |
$643.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.75
|
| Rate for Payer: Multiplan Commercial |
$713.25
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$74.93 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$284.42
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$280.28
|
| Rate for Payer: Heritage Provider Network Senior |
$280.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.50
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$284.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.77
|
| Rate for Payer: Blue Shield of California Commercial |
$83.23
|
| Rate for Payer: Blue Shield of California EPN |
$47.33
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$269.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: Dignity Health Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$269.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$256.27
|
| Rate for Payer: Heritage Provider Network Senior |
$256.27
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$215.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143.06
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$113.54
|
| Rate for Payer: TriValley Medical Group Senior |
$113.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC NEFF SET
|
Facility
|
IP
|
$452.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909001087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.81 |
| Max. Negotiated Rate |
$339.00 |
| Rate for Payer: Adventist Health Commercial |
$90.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$310.52
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$306.00
|
| Rate for Payer: Heritage Provider Network Senior |
$306.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.00
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
|
|
HC NEFF SET
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909001087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.81 |
| Max. Negotiated Rate |
$384.20 |
| Rate for Payer: Adventist Health Commercial |
$90.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$93.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$310.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$384.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$280.69
|
| Rate for Payer: Blue Shield of California EPN |
$265.32
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$293.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$384.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$384.20
|
| Rate for Payer: Dignity Health Senior |
$384.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$279.79
|
| Rate for Payer: Heritage Provider Network Senior |
$279.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$217.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.00
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$384.20
|
| Rate for Payer: Vantage Medical Group Senior |
$384.20
|
|
|
HC NEGATIVE URINE COMBO PANEL 61
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912450
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$138.75 |
| Rate for Payer: Adventist Health Commercial |
$37.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.56
|
| Rate for Payer: Blue Shield of California Commercial |
$63.11
|
| Rate for Payer: Blue Shield of California EPN |
$49.34
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$114.52
|
| Rate for Payer: Heritage Provider Network Senior |
$114.52
|
| Rate for Payer: Humana Medicare |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$138.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC NEGATIVE URINE COMBO PANEL 61
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912450
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.36 |
| Max. Negotiated Rate |
$167.25 |
| Rate for Payer: Adventist Health Commercial |
$44.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$153.20
|
| Rate for Payer: Cash Price |
$100.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$150.97
|
| Rate for Payer: Heritage Provider Network Senior |
$150.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.75
|
| Rate for Payer: Multiplan Commercial |
$167.25
|
|
|
HC NEG PRESS WOUND THERAPY MECH GT 50 SQ CM
|
Facility
|
IP
|
$614.00
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
900101508
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.13 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Adventist Health Commercial |
$122.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$421.82
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$415.68
|
| Rate for Payer: Heritage Provider Network Senior |
$415.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.50
|
| Rate for Payer: Multiplan Commercial |
$460.50
|
|
|
HC NEG PRESS WOUND THERAPY MECH GT 50 SQ CM
|
Facility
|
OP
|
$614.00
|
|
|
Service Code
|
CPT 97608
|
| Hospital Charge Code |
900101508
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.13 |
| Max. Negotiated Rate |
$3,224.00 |
| Rate for Payer: Adventist Health Commercial |
$122.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$510.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$421.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Blue Shield of California Commercial |
$381.29
|
| Rate for Payer: Blue Shield of California EPN |
$360.42
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$399.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,224.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$380.07
|
| Rate for Payer: Heritage Provider Network Senior |
$380.07
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$460.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$548.02
|
| Rate for Payer: TriValley Medical Group Senior |
$548.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC NEG PRESS WOUND THERAPY MECH LT 50 SQ CM
|
Facility
|
OP
|
$614.00
|
|
|
Service Code
|
CPT 97607
|
| Hospital Charge Code |
900101534
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.13 |
| Max. Negotiated Rate |
$3,224.00 |
| Rate for Payer: Adventist Health Commercial |
$122.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$387.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$421.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Blue Shield of California Commercial |
$381.29
|
| Rate for Payer: Blue Shield of California EPN |
$360.42
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cash Price |
$276.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$399.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,224.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$380.07
|
| Rate for Payer: Heritage Provider Network Senior |
$380.07
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$460.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$548.02
|
| Rate for Payer: TriValley Medical Group Senior |
$548.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
