|
HC FETAL BLEED SCREEN
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
900904562
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$53.58 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$190.62
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$200.39
|
| Rate for Payer: Heritage Provider Network Senior |
$200.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.00
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
|
|
HC FETAL CORD OCCLUS ADDL FETUS
|
Facility
|
IP
|
$812.00
|
|
|
Service Code
|
CPT 59072
|
| Hospital Charge Code |
910400091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$609.00 |
| Rate for Payer: Adventist Health Commercial |
$162.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$522.93
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$549.72
|
| Rate for Payer: Heritage Provider Network Senior |
$549.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
|
|
HC FETAL CORD OCCLUS ADDL FETUS
|
Facility
|
OP
|
$812.00
|
|
|
Service Code
|
CPT 59072
|
| Hospital Charge Code |
910400091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$162.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$501.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$495.32
|
| Rate for Payer: Blue Shield of California EPN |
$396.26
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$391.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$502.63
|
| Rate for Payer: Heritage Provider Network Senior |
$502.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$387.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$450.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$406.00
|
| Rate for Payer: TriValley Medical Group Senior |
$406.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$406.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$406.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC FETAL CORD OCCLUSION
|
Facility
|
IP
|
$812.00
|
|
|
Service Code
|
CPT 59072
|
| Hospital Charge Code |
910400090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$609.00 |
| Rate for Payer: Adventist Health Commercial |
$162.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$522.93
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$549.72
|
| Rate for Payer: Heritage Provider Network Senior |
$549.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
|
|
HC FETAL CORD OCCLUSION
|
Facility
|
OP
|
$812.00
|
|
|
Service Code
|
CPT 59072
|
| Hospital Charge Code |
910400090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$162.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$501.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$495.32
|
| Rate for Payer: Blue Shield of California EPN |
$396.26
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$391.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$502.63
|
| Rate for Payer: Heritage Provider Network Senior |
$502.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$387.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$450.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$406.00
|
| Rate for Payer: TriValley Medical Group Senior |
$406.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$406.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$406.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC FETAL DOPPLER MID CEREBRAL ART
|
Facility
|
IP
|
$960.00
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
906601316
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$173.76 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Adventist Health Commercial |
$192.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$618.24
|
| Rate for Payer: Cash Price |
$432.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$649.92
|
| Rate for Payer: Heritage Provider Network Senior |
$649.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$173.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
|
|
HC FETAL DOPPLER MID CEREBRAL ART
|
Facility
|
OP
|
$960.00
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
906601316
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.67 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Adventist Health Commercial |
$192.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$593.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$480.19
|
| Rate for Payer: Blue Shield of California Commercial |
$342.58
|
| Rate for Payer: Blue Shield of California EPN |
$275.49
|
| Rate for Payer: Cash Price |
$432.00
|
| Rate for Payer: Cash Price |
$432.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$624.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$566.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$134.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$594.24
|
| Rate for Payer: Heritage Provider Network Senior |
$594.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$457.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$173.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$134.46
|
| Rate for Payer: TriValley Medical Group Senior |
$134.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC FETAL DOPPLER UMBILICAL ARTERY
|
Facility
|
OP
|
$439.00
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
906601315
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.46 |
| Max. Negotiated Rate |
$342.58 |
| Rate for Payer: Adventist Health Commercial |
$87.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$271.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.59
|
| Rate for Payer: Blue Shield of California Commercial |
$342.58
|
| Rate for Payer: Blue Shield of California EPN |
$275.49
|
| Rate for Payer: Cash Price |
$197.55
|
| Rate for Payer: Cash Price |
$197.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$285.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.01
|
| Rate for Payer: EPIC Health Plan Medicare |
$134.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$271.74
|
| Rate for Payer: Heritage Provider Network Senior |
$271.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$209.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$329.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$134.46
|
| Rate for Payer: TriValley Medical Group Senior |
$134.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC FETAL DOPPLER UMBILICAL ARTERY
|
Facility
|
IP
|
$439.00
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
906601315
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.46 |
| Max. Negotiated Rate |
$329.25 |
| Rate for Payer: Adventist Health Commercial |
$87.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$282.72
|
| Rate for Payer: Cash Price |
$197.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$297.20
|
| Rate for Payer: Heritage Provider Network Senior |
$297.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.75
|
| Rate for Payer: Multiplan Commercial |
$329.25
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
IP
|
$1,778.00
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
900912319
|
|
Hospital Revenue Code
|
304
|
| Min. Negotiated Rate |
$321.82 |
| Max. Negotiated Rate |
$1,333.50 |
| Rate for Payer: Adventist Health Commercial |
$355.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,145.03
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,203.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,203.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$321.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.50
|
| Rate for Payer: Multiplan Commercial |
$1,333.50
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
900912319
|
|
Hospital Revenue Code
|
304
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$1,278.44 |
| Rate for Payer: Adventist Health Commercial |
$41.00
|
| Rate for Payer: Adventist Health Commercial |
$355.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,098.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$126.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,278.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,278.44
|
| Rate for Payer: Blue Shield of California Commercial |
$518.34
|
| Rate for Payer: Blue Shield of California Commercial |
$518.34
|
| Rate for Payer: Blue Shield of California EPN |
$415.75
|
| Rate for Payer: Blue Shield of California EPN |
$415.75
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,155.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$133.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,049.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$64.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$64.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,100.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$126.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1,100.58
|
| Rate for Payer: Heritage Provider Network Senior |
$126.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$848.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$97.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$321.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.31
|
| Rate for Payer: Multiplan Commercial |
$1,333.50
|
| Rate for Payer: Multiplan Commercial |
$153.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$64.41
|
| Rate for Payer: TriValley Medical Group Commercial |
$64.41
|
| Rate for Payer: TriValley Medical Group Senior |
$64.41
|
| Rate for Payer: TriValley Medical Group Senior |
$64.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$69.56
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$69.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$69.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$69.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Vantage Medical Group Senior |
$64.41
|
| Rate for Payer: Vantage Medical Group Senior |
$64.41
|
|
|
HC FETAL FLUID DRAIN INCLUD US GU
|
Facility
|
IP
|
$1,111.00
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
910400098
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$201.09 |
| Max. Negotiated Rate |
$833.25 |
| Rate for Payer: Adventist Health Commercial |
$222.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$715.48
|
| Rate for Payer: Cash Price |
$499.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$752.15
|
| Rate for Payer: Heritage Provider Network Senior |
$752.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.75
|
| Rate for Payer: Multiplan Commercial |
$833.25
|
|
|
HC FETAL FLUID DRAIN INCLUD US GU
|
Facility
|
OP
|
$1,111.00
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
910400098
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$201.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$222.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$686.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$677.71
|
| Rate for Payer: Blue Shield of California EPN |
$542.17
|
| Rate for Payer: Cash Price |
$499.95
|
| Rate for Payer: Cash Price |
$499.95
|
| Rate for Payer: Cash Price |
$499.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$391.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$687.71
|
| Rate for Payer: Heritage Provider Network Senior |
$687.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$529.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$450.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$833.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$555.50
|
| Rate for Payer: TriValley Medical Group Senior |
$555.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$555.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$555.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC FETAL LUNG MATURITY (FLM)
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 83663
|
| Hospital Charge Code |
900910962
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$403.50 |
| Rate for Payer: Adventist Health Commercial |
$107.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$346.47
|
| Rate for Payer: Cash Price |
$242.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$364.23
|
| Rate for Payer: Heritage Provider Network Senior |
$364.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.50
|
| Rate for Payer: Multiplan Commercial |
$403.50
|
|
|
HC FETAL LUNG MATURITY (FLM)
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 83663
|
| Hospital Charge Code |
900910962
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.91 |
| Max. Negotiated Rate |
$403.50 |
| Rate for Payer: Adventist Health Commercial |
$107.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$332.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.75
|
| Rate for Payer: Blue Shield of California Commercial |
$152.24
|
| Rate for Payer: Blue Shield of California EPN |
$122.11
|
| Rate for Payer: Cash Price |
$242.10
|
| Rate for Payer: Cash Price |
$242.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$349.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$317.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$333.02
|
| Rate for Payer: Heritage Provider Network Senior |
$333.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$256.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.34
|
| Rate for Payer: Multiplan Commercial |
$403.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.91
|
| Rate for Payer: TriValley Medical Group Senior |
$18.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.80
|
| Rate for Payer: Vantage Medical Group Senior |
$18.91
|
|
|
HC FETAL NON-STRESS TEST
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
902400362
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$700.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$260.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$540.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$299.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$286.03
|
| Rate for Payer: TriValley Medical Group Senior |
$260.03
|
| 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 |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC FETAL NON-STRESS TEST
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
902400362
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$730.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL NON-STRESS TEST ADDL FETUS
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025 59
|
| Hospital Charge Code |
910400087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$730.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL NON-STRESS TEST ADDL FETUS
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025 59
|
| Hospital Charge Code |
910400087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$700.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$963.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$623.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$963.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$963.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$963.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$540.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$793.80
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$567.00
|
| Rate for Payer: TriValley Medical Group Senior |
$567.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$567.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$567.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$963.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$963.90
|
| Rate for Payer: Vantage Medical Group Senior |
$963.90
|
|
|
HC FETAL NON-STRESS TEST SINGLE FETUS
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
910400086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$700.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$691.74
|
| Rate for Payer: Blue Shield of California EPN |
$553.39
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$260.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$540.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$299.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$567.00
|
| Rate for Payer: TriValley Medical Group Senior |
$567.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$567.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$567.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC FETAL NON-STRESS TEST SINGLE FETUS
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
910400086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$730.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC FETAL SHUNT PLACMNT ADDL FETUS
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT 59076
|
| Hospital Charge Code |
910400093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$659.25 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$566.08
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
|
|
HC FETAL SHUNT PLACMNT ADDL FETUS
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 59076
|
| Hospital Charge Code |
910400093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$543.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$536.19
|
| Rate for Payer: Blue Shield of California EPN |
$428.95
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$391.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.10
|
| Rate for Payer: Heritage Provider Network Senior |
$544.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$419.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$450.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$439.50
|
| Rate for Payer: TriValley Medical Group Senior |
$439.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$439.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$439.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$168.73
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$177.37
|
| Rate for Payer: Heritage Provider Network Senior |
$177.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.58
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$162.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.90
|
| Rate for Payer: Heritage Provider Network Senior |
$162.18
|
| Rate for Payer: Heritage Provider Network Senior |
$22.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$124.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$17.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
