|
HC FSH
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
900910818
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.87 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$173.88
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.79
|
| Rate for Payer: Heritage Provider Network Senior |
$182.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
|
|
HC FSH
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
900910818
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.58 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Adventist Health Commercial |
$25.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.42
|
| Rate for Payer: Blue Shield of California Commercial |
$149.59
|
| Rate for Payer: Blue Shield of California Commercial |
$149.59
|
| Rate for Payer: Blue Shield of California EPN |
$119.98
|
| Rate for Payer: Blue Shield of California EPN |
$119.98
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$58.05
|
| Rate for Payer: Cash Price |
$58.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$83.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$175.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.11
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.58
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$79.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$167.13
|
| Rate for Payer: Heritage Provider Network Senior |
$79.85
|
| Rate for Payer: Heritage Provider Network Senior |
$167.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$61.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$128.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.90
|
| Rate for Payer: Multiplan Commercial |
$96.75
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.58
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.58
|
| Rate for Payer: TriValley Medical Group Senior |
$18.58
|
| Rate for Payer: TriValley Medical Group Senior |
$18.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.44
|
| Rate for Payer: Vantage Medical Group Senior |
$18.58
|
| Rate for Payer: Vantage Medical Group Senior |
$18.58
|
|
|
HC FULL THCKNESS GRAFT LT 20SQ CM
|
Facility
|
OP
|
$7,646.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
900501513
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,383.93 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,529.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,725.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,631.85
|
| Rate for Payer: Blue Shield of California EPN |
$2,890.19
|
| Rate for Payer: Cash Price |
$3,440.70
|
| Rate for Payer: Cash Price |
$3,440.70
|
| Rate for Payer: Cash Price |
$3,440.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,969.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,653.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,176.34
|
| Rate for Payer: Heritage Provider Network Senior |
$5,176.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,647.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,383.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,051.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,555.98
|
| Rate for Payer: Multiplan Commercial |
$5,734.50
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,587.60
|
| Rate for Payer: TriValley Medical Group Senior |
$4,587.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
HC FULL THCKNESS GRAFT LT 20SQ CM
|
Facility
|
IP
|
$7,646.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
900501513
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,383.93 |
| Max. Negotiated Rate |
$5,734.50 |
| Rate for Payer: Adventist Health Commercial |
$1,529.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,924.02
|
| Rate for Payer: Cash Price |
$3,440.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,176.34
|
| Rate for Payer: Heritage Provider Network Senior |
$5,176.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,383.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.50
|
| Rate for Payer: Multiplan Commercial |
$5,734.50
|
|
|
HC FULL THCKNESS GRAFT,LT 20SQ CM
|
Facility
|
IP
|
$8,392.00
|
|
|
Service Code
|
CPT 15220
|
| Hospital Charge Code |
900501388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,518.95 |
| Max. Negotiated Rate |
$6,294.00 |
| Rate for Payer: Adventist Health Commercial |
$1,678.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,404.45
|
| Rate for Payer: Cash Price |
$3,776.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,681.38
|
| Rate for Payer: Heritage Provider Network Senior |
$5,681.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,518.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,098.00
|
| Rate for Payer: Multiplan Commercial |
$6,294.00
|
|
|
HC FULL THCKNESS GRAFT,LT 20SQ CM
|
Facility
|
OP
|
$8,392.00
|
|
|
Service Code
|
CPT 15220
|
| Hospital Charge Code |
900501388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,518.95 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Multiplan Commercial |
$6,294.00
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Adventist Health Commercial |
$1,678.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,186.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,986.20
|
| Rate for Payer: Blue Shield of California EPN |
$3,172.18
|
| Rate for Payer: Cash Price |
$3,776.40
|
| Rate for Payer: Cash Price |
$3,776.40
|
| Rate for Payer: Cash Price |
$3,776.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,454.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,653.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,681.38
|
| Rate for Payer: Heritage Provider Network Senior |
$5,681.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,002.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,518.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,051.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,098.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,555.98
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,035.20
|
| Rate for Payer: TriValley Medical Group Senior |
$5,035.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
HC FULL THKNS GRFT LT 20SQ CM FCE
|
Facility
|
OP
|
$7,911.00
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
900501754
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,431.89 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,582.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,889.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,757.72
|
| Rate for Payer: Blue Shield of California EPN |
$2,990.36
|
| Rate for Payer: Cash Price |
$3,559.95
|
| Rate for Payer: Cash Price |
$3,559.95
|
| Rate for Payer: Cash Price |
$3,559.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,142.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,653.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,355.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,355.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,773.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,431.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,051.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,977.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,555.98
|
| Rate for Payer: Multiplan Commercial |
$5,933.25
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,746.60
|
| Rate for Payer: TriValley Medical Group Senior |
$4,746.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
HC FULL THKNS GRFT LT 20SQ CM FCE
|
Facility
|
IP
|
$7,911.00
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
900501754
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,431.89 |
| Max. Negotiated Rate |
$5,933.25 |
| Rate for Payer: Adventist Health Commercial |
$1,582.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,094.68
|
| Rate for Payer: Cash Price |
$3,559.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,355.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,355.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,431.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,977.75
|
| Rate for Payer: Multiplan Commercial |
$5,933.25
|
|
|
HC FUSION OF TENDONS AT WRIST
|
Facility
|
OP
|
$7,359.00
|
|
|
Service Code
|
CPT 25300
|
| Hospital Charge Code |
900501447
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,331.98 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,471.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,547.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,495.53
|
| Rate for Payer: Blue Shield of California EPN |
$2,781.70
|
| Rate for Payer: Cash Price |
$3,311.55
|
| Rate for Payer: Cash Price |
$3,311.55
|
| Rate for Payer: Cash Price |
$3,311.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,783.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,208.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,982.04
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,510.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,331.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,839.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,839.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$5,519.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,415.40
|
| Rate for Payer: TriValley Medical Group Senior |
$4,415.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC FUSION OF TENDONS AT WRIST
|
Facility
|
IP
|
$7,359.00
|
|
|
Service Code
|
CPT 25300
|
| Hospital Charge Code |
900501447
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,331.98 |
| Max. Negotiated Rate |
$5,519.25 |
| Rate for Payer: Adventist Health Commercial |
$1,471.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,739.20
|
| Rate for Payer: Cash Price |
$3,311.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,982.04
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,331.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,839.75
|
| Rate for Payer: Multiplan Commercial |
$5,519.25
|
|
|
HC GA-67 GALLIUM PER MCI
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT A9556
|
| Hospital Charge Code |
909301528
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Adventist Health Commercial |
$55.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$177.74
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$126.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$127.79
|
| Rate for Payer: Heritage Provider Network Senior |
$127.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$99.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$91.38
|
|
|
HC GA-67 GALLIUM PER MCI
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT A9556
|
| Hospital Charge Code |
909301528
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$234.60 |
| Rate for Payer: Adventist Health Commercial |
$55.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$234.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.54
|
| Rate for Payer: Blue Shield of California Commercial |
$168.36
|
| Rate for Payer: Blue Shield of California EPN |
$134.69
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$126.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$234.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$234.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$127.79
|
| Rate for Payer: Heritage Provider Network Senior |
$127.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$131.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$110.40
|
| Rate for Payer: TriValley Medical Group Senior |
$110.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$99.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$91.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$234.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.60
|
| Rate for Payer: Vantage Medical Group Senior |
$234.60
|
|
|
HC GADOLINIUM MR CONTRAST PER ML
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
CPT A9579
|
| Hospital Charge Code |
909081000
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.73
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.56
|
| Rate for Payer: Heritage Provider Network Senior |
$5.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.97
|
|
|
HC GADOLINIUM MR CONTRAST PER ML
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
CPT A9579
|
| Hospital Charge Code |
909081000
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.69
|
| Rate for Payer: Blue Shield of California Commercial |
$7.32
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.56
|
| Rate for Payer: Heritage Provider Network Senior |
$5.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.80
|
| Rate for Payer: TriValley Medical Group Senior |
$4.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
HC GADOXETATE DISODIUM PER ML
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT A9581
|
| Hospital Charge Code |
908801701
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$18.82 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$66.98
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$70.41
|
| Rate for Payer: Heritage Provider Network Senior |
$70.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$34.43
|
|
|
HC GADOXETATE DISODIUM PER ML
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT A9581
|
| Hospital Charge Code |
908801701
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$18.82 |
| Max. Negotiated Rate |
$88.40 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$88.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.51
|
| Rate for Payer: Blue Shield of California Commercial |
$63.44
|
| Rate for Payer: Blue Shield of California EPN |
$50.75
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$67.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$88.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$88.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$88.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$64.38
|
| Rate for Payer: Heritage Provider Network Senior |
$64.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$49.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$72.80
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$34.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$88.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$88.40
|
| Rate for Payer: Vantage Medical Group Senior |
$88.40
|
|
|
HC GAIT TRAINING 15 MIN MCAL
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
900400037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.04
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
|
|
HC GAIT TRAINING 15 MIN MCAL
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
900400037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Adventist Health Commercial |
$41.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$85.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.52
|
| Rate for Payer: Heritage Provider Network Senior |
$62.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$48.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.70
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.85
|
| Rate for Payer: Vantage Medical Group Senior |
$85.85
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103143
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$41.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$85.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.52
|
| Rate for Payer: Heritage Provider Network Senior |
$62.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$48.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.70
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.85
|
| Rate for Payer: Vantage Medical Group Senior |
$85.85
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
900417116
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.04
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
900417116
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$41.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$85.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.52
|
| Rate for Payer: Heritage Provider Network Senior |
$62.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$48.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.70
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.85
|
| Rate for Payer: Vantage Medical Group Senior |
$85.85
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103143
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.04
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
|
|
HC GAIT TRAINING 30 MIN PT
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103363
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$41.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$85.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.52
|
| Rate for Payer: Heritage Provider Network Senior |
$62.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$48.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.70
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.85
|
| Rate for Payer: Vantage Medical Group Senior |
$85.85
|
|
|
HC GAIT TRAINING 30 MIN PT
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103363
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.04
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
|
|
HC GAL D 1 (EGG WHITE), IGE
|
Facility
|
OP
|
$13.27
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913722
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$2.65
|
| Rate for Payer: Adventist Health Commercial |
$2.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.21
|
| Rate for Payer: Heritage Provider Network Senior |
$6.85
|
| Rate for Payer: Heritage Provider Network Senior |
$8.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$6.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$8.29
|
| Rate for Payer: Multiplan Commercial |
$9.95
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
