|
HC OPTIC FORAMINA
|
Facility
|
OP
|
$502.00
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
909001112
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.53 |
| Max. Negotiated Rate |
$376.50 |
| Rate for Payer: Adventist Health Commercial |
$100.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$56.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$344.87
|
| 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 |
$148.88
|
| Rate for Payer: Blue Shield of California Commercial |
$127.22
|
| Rate for Payer: Blue Shield of California EPN |
$72.34
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$326.30
|
| 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 |
$326.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$310.74
|
| Rate for Payer: Heritage Provider Network Senior |
$310.74
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.53
|
| 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 |
$90.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.50
|
| 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 |
$376.50
|
| 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 ORBITS
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
909001111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$119.46 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$453.42
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$446.82
|
| Rate for Payer: Heritage Provider Network Senior |
$446.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.00
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
|
|
HC ORBITS
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
909001111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$67.79
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$453.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.17
|
| Rate for Payer: Blue Shield of California Commercial |
$161.94
|
| Rate for Payer: Blue Shield of California EPN |
$92.09
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$429.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: Dignity Health Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$137.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.54
|
| Rate for Payer: Heritage Provider Network Senior |
$408.54
|
| Rate for Payer: Humana Medicare |
$137.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$59.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$260.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.07
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$137.36
|
| Rate for Payer: TriValley Medical Group Senior |
$137.36
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ORTHOTIC FITTING TRAINING 15 MIN MCAL
|
Facility
|
OP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900400049
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$187.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| 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 |
$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 |
$232.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.05
|
| Rate for Payer: Dignity Health Senior |
$232.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$168.99
|
| Rate for Payer: Heritage Provider Network Senior |
$168.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.59
|
| 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
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.05
|
| Rate for Payer: Vantage Medical Group Senior |
$232.05
|
|
|
HC ORTHOTIC FITTING TRAINING 15 MIN MCAL
|
Facility
|
IP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900400049
|
|
Hospital Revenue Code
|
420
|
| 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 ORTHOTIC FITTING/TRAINING 15 MIN OT
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
905104150
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$114.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$141.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$91.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| 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 |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$108.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$141.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$141.95
|
| Rate for Payer: Dignity Health Senior |
$141.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$103.37
|
| Rate for Payer: Heritage Provider Network Senior |
$103.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.75
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$141.95
|
| Rate for Payer: Vantage Medical Group Senior |
$141.95
|
|
|
HC ORTHOTIC FITTING/TRAINING 15 MIN OT
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
905104150
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$114.73
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$113.06
|
| Rate for Payer: Heritage Provider Network Senior |
$113.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.75
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
|
|
HC ORTHOTIC FITTING/TRAINING 15 MIN PT
|
Facility
|
IP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900417504
|
|
Hospital Revenue Code
|
420
|
| 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 ORTHOTIC FITTING/TRAINING 15 MIN PT
|
Facility
|
OP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900417504
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$187.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| 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 |
$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 |
$232.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.05
|
| Rate for Payer: Dignity Health Senior |
$232.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$168.99
|
| Rate for Payer: Heritage Provider Network Senior |
$168.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.59
|
| 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
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.05
|
| Rate for Payer: Vantage Medical Group Senior |
$232.05
|
|
|
HC ORTHOTIC FITTING/TRAINING 15 MIN PT
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
905103150
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$114.73
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$113.06
|
| Rate for Payer: Heritage Provider Network Senior |
$113.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.75
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
|
|
HC ORTHOTIC FITTING/TRAINING 15 MIN PT
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
905103150
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$114.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$141.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$91.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| 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 |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$108.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$141.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$141.95
|
| Rate for Payer: Dignity Health Senior |
$141.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$103.37
|
| Rate for Payer: Heritage Provider Network Senior |
$103.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.75
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$141.95
|
| Rate for Payer: Vantage Medical Group Senior |
$141.95
|
|
|
HC ORTHOTICS LE EVALUATION
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT L2999
|
| Hospital Charge Code |
905302999
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.10
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
|
|
HC ORTHOTICS LE EVALUATION
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT L2999
|
| Hospital Charge Code |
905302999
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$186.30
|
| Rate for Payer: Blue Shield of California EPN |
$176.10
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.00
|
| Rate for Payer: Dignity Health Senior |
$255.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.90
|
| Rate for Payer: Heritage Provider Network Senior |
$138.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.00
|
| Rate for Payer: Vantage Medical Group Senior |
$255.00
|
|
|
HC ORTHOTICS SPINAL EVALUATION
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT L1499
|
| Hospital Charge Code |
905301499
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$186.30
|
| Rate for Payer: Blue Shield of California EPN |
$176.10
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.00
|
| Rate for Payer: Dignity Health Senior |
$255.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.90
|
| Rate for Payer: Heritage Provider Network Senior |
$138.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.00
|
| Rate for Payer: Vantage Medical Group Senior |
$255.00
|
|
|
HC ORTHOTICS SPINAL EVALUATION
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT L1499
|
| Hospital Charge Code |
905301499
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.10
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
|
|
HC ORTHOTICS UE EVALUATION
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT L3999
|
| Hospital Charge Code |
905303999
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.10
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
|
|
HC ORTHOTICS UE EVALUATION
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT L3999
|
| Hospital Charge Code |
905303999
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$144.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$206.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$186.30
|
| Rate for Payer: Blue Shield of California EPN |
$176.10
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$138.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.00
|
| Rate for Payer: Dignity Health Senior |
$255.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.90
|
| Rate for Payer: Heritage Provider Network Senior |
$138.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$109.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.00
|
| Rate for Payer: Vantage Medical Group Senior |
$255.00
|
|
|
HC ORTHOTIC TRAINING 15 MIN MCAL
|
Facility
|
IP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
901300078
|
|
Hospital Revenue Code
|
430
|
| 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 ORTHOTIC TRAINING 15 MIN MCAL
|
Facility
|
OP
|
$273.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
901300078
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$187.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| 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 |
$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 |
$232.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.05
|
| Rate for Payer: Dignity Health Senior |
$232.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$168.99
|
| Rate for Payer: Heritage Provider Network Senior |
$168.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.59
|
| 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
|
| 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 |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.05
|
| Rate for Payer: Vantage Medical Group Senior |
$232.05
|
|
|
HC OSCALSIS (HEEL)
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
909001633
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC OSCALSIS (HEEL)
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
909001633
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.67 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$44.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| 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 |
$113.38
|
| Rate for Payer: Blue Shield of California Commercial |
$94.97
|
| Rate for Payer: Blue Shield of California EPN |
$54.01
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| 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 |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.67
|
| 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 |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| 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 |
$292.50
|
| 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 OSMOLALITY SERUM
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
900910264
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.54 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Adventist Health Commercial |
$44.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$153.89
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$151.65
|
| Rate for Payer: Heritage Provider Network Senior |
$151.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
900910264
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Adventist Health Commercial |
$44.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$153.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.34
|
| Rate for Payer: Blue Shield of California Commercial |
$51.65
|
| Rate for Payer: Blue Shield of California EPN |
$40.38
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$145.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.27
|
| Rate for Payer: Dignity Health Senior |
$6.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$145.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.66
|
| Rate for Payer: Heritage Provider Network Senior |
$138.66
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.33
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.61
|
| Rate for Payer: TriValley Medical Group Senior |
$6.61
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Vantage Medical Group Senior |
$6.61
|
|
|
HC OSMOLALITY STOOL
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
900910358
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.88 |
| Max. Negotiated Rate |
$194.25 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$177.93
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$175.34
|
| Rate for Payer: Heritage Provider Network Senior |
$175.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.75
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
|
|
HC OSMOLALITY STOOL
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
900910358
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$57.08 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.08
|
| Rate for Payer: Blue Shield of California Commercial |
$53.22
|
| Rate for Payer: Blue Shield of California EPN |
$41.60
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.50
|
| Rate for Payer: Dignity Health Senior |
$6.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.09
|
| Rate for Payer: Heritage Provider Network Senior |
$16.09
|
| Rate for Payer: Humana Medicare |
$6.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.59
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.82
|
| Rate for Payer: TriValley Medical Group Senior |
$6.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6.82
|
|
