|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,003.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$200.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$689.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$611.83
|
| Rate for Payer: Blue Shield of California EPN |
$489.46
|
| Rate for Payer: Cash Price |
$551.65
|
| Rate for Payer: Cash Price |
$551.65
|
| Rate for Payer: Cash Price |
$551.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$651.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$620.86
|
| Rate for Payer: Heritage Provider Network Senior |
$620.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$161.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$478.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$181.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$752.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$180.16
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$501.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$551.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$489.83
|
| Rate for Payer: Blue Shield of California EPN |
$391.86
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$521.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$497.06
|
| Rate for Payer: Heritage Provider Network Senior |
$497.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$161.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$383.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$180.16
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$401.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$401.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$602.25 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$543.63
|
| Rate for Payer: Heritage Provider Network Senior |
$543.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$602.25 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$543.63
|
| Rate for Payer: Heritage Provider Network Senior |
$543.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,003.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$181.54 |
| Max. Negotiated Rate |
$752.25 |
| Rate for Payer: Adventist Health Commercial |
$200.60
|
| Rate for Payer: Cash Price |
$551.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$679.03
|
| Rate for Payer: Heritage Provider Network Senior |
$679.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$181.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.75
|
| Rate for Payer: Multiplan Commercial |
$752.25
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
IP
|
$14,633.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,648.57 |
| Max. Negotiated Rate |
$10,974.75 |
| Rate for Payer: Adventist Health Commercial |
$2,926.60
|
| Rate for Payer: Cash Price |
$8,048.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,906.54
|
| Rate for Payer: Heritage Provider Network Senior |
$9,906.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,658.25
|
| Rate for Payer: Multiplan Commercial |
$10,974.75
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$14,633.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,974.75 |
| Rate for Payer: Adventist Health Commercial |
$2,926.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,052.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$8,048.15
|
| Rate for Payer: Cash Price |
$8,048.15
|
| Rate for Payer: Cash Price |
$8,048.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,511.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,057.83
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$424.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,658.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$10,974.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$542.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$513.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Senior |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$376.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$250.49
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
| Rate for Payer: Multiplan WC |
$316.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$284.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$261.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$592.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$542.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$481.90
|
| Rate for Payer: Blue Shield of California EPN |
$385.52
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$513.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Senior |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$489.01
|
| Rate for Payer: Heritage Provider Network Senior |
$489.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$174.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$376.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$250.49
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$218.68
|
| Rate for Payer: TriValley Medical Group Senior |
$198.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$395.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$395.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$592.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Cash Price |
$434.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$14,278.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$568.75 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$2,855.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,808.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,136.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,852.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,708.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$7,852.90
|
| Rate for Payer: Cash Price |
$7,852.90
|
| Rate for Payer: Cash Price |
$7,852.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,280.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,136.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,136.30
|
| Rate for Payer: Dignity Health Senior |
$12,136.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,838.08
|
| Rate for Payer: Heritage Provider Network Senior |
$8,838.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,810.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,584.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,569.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,994.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,994.60
|
| Rate for Payer: Multiplan Commercial |
$10,708.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,136.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,136.30
|
| Rate for Payer: Vantage Medical Group Senior |
$12,136.30
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$12,136.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,196.62 |
| Max. Negotiated Rate |
$9,102.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,216.07
|
| Rate for Payer: Heritage Provider Network Senior |
$8,216.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$12,136.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$568.75 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,337.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,674.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,102.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cash Price |
$6,674.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,888.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,315.60
|
| Rate for Payer: Dignity Health Senior |
$10,315.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,512.18
|
| Rate for Payer: Heritage Provider Network Senior |
$7,512.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,788.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,495.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,495.20
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Senior |
$10,315.60
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$14,278.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,584.32 |
| Max. Negotiated Rate |
$10,708.50 |
| Rate for Payer: Adventist Health Commercial |
$2,855.60
|
| Rate for Payer: Cash Price |
$7,852.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,666.21
|
| Rate for Payer: Heritage Provider Network Senior |
$9,666.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,584.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,569.50
|
| Rate for Payer: Multiplan Commercial |
$10,708.50
|
|
|
HC INSJ PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
OP
|
$23,888.00
|
|
|
Service Code
|
CPT 0918T
|
| Hospital Charge Code |
906811506
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,411.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,527.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Senior |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,786.67
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19,979.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,249.48
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,567.01
|
| Rate for Payer: TriValley Medical Group Senior |
$10,515.46
|
| 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 |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC INSJ PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
IP
|
$23,888.00
|
|
|
Service Code
|
CPT 0918T
|
| Hospital Charge Code |
906811506
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,323.73 |
| Max. Negotiated Rate |
$17,916.00 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
|
|
HC INSJ PERM CCM DFIB SYS PG AND ELTRD
|
Facility
|
OP
|
$92,542.00
|
|
|
Service Code
|
CPT 0915T
|
| Hospital Charge Code |
906811503
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$18,508.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$63,576.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$60,152.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$57,283.50
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,750.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,135.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$69,406.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$40,737.44
|
| 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 |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC INSJ PERM CCM DFIB SYS PG AND ELTRD
|
Facility
|
IP
|
$92,542.00
|
|
|
Service Code
|
CPT 0915T
|
| Hospital Charge Code |
906811503
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$69,406.50 |
| Rate for Payer: Adventist Health Commercial |
$18,508.40
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Cash Price |
$50,898.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,750.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,135.50
|
| Rate for Payer: Multiplan Commercial |
$69,406.50
|
|
|
HC INSJ PERM CCM DFIB SYS PULSE GEN ONLY
|
Facility
|
IP
|
$64,789.00
|
|
|
Service Code
|
CPT 0916T
|
| Hospital Charge Code |
906811504
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$48,591.75 |
| Rate for Payer: Adventist Health Commercial |
$12,957.80
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,726.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,197.25
|
| Rate for Payer: Multiplan Commercial |
$48,591.75
|
|
|
HC INSJ PERM CCM DFIB SYS PULSE GEN ONLY
|
Facility
|
OP
|
$64,789.00
|
|
|
Service Code
|
CPT 0916T
|
| Hospital Charge Code |
906811504
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$54,188.25 |
| Rate for Payer: Adventist Health Commercial |
$12,957.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44,510.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Cash Price |
$35,633.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42,112.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Senior |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,520.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$40,104.39
|
| Rate for Payer: Heritage Provider Network Senior |
$35,079.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54,188.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,726.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,798.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,197.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,935.36
|
| Rate for Payer: Multiplan Commercial |
$48,591.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,372.14
|
| Rate for Payer: TriValley Medical Group Senior |
$28,520.13
|
| 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 |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC INSJ PERM CCM DFIB SYS SINGLE LEAD
|
Facility
|
IP
|
$23,888.00
|
|
|
Service Code
|
CPT 0917T
|
| Hospital Charge Code |
906811505
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,323.73 |
| Max. Negotiated Rate |
$17,916.00 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
|
|
HC INSJ PERM CCM DFIB SYS SINGLE LEAD
|
Facility
|
OP
|
$23,888.00
|
|
|
Service Code
|
CPT 0917T
|
| Hospital Charge Code |
906811505
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$19,979.37 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,411.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cash Price |
$13,138.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,527.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Senior |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,786.67
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19,979.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,249.48
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,567.01
|
| Rate for Payer: TriValley Medical Group Senior |
$10,515.46
|
| 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 |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,205.67 |
| Max. Negotiated Rate |
$9,139.50 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Cash Price |
$6,702.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,249.92
|
| Rate for Payer: Heritage Provider Network Senior |
$8,249.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,205.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,046.50
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,371.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$6,702.30
|
| Rate for Payer: Cash Price |
$6,702.30
|
| Rate for Payer: Cash Price |
$6,702.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,920.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,543.13
|
| Rate for Payer: Heritage Provider Network Senior |
$8,448.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,050.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,205.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,046.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,555.33
|
| Rate for Payer: TriValley Medical Group Senior |
$7,555.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
