|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$3,587.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$649.25 |
| Max. Negotiated Rate |
$2,690.25 |
| Rate for Payer: Adventist Health Commercial |
$717.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,464.27
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,428.40
|
| Rate for Payer: Heritage Provider Network Senior |
$2,428.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$649.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$896.75
|
| Rate for Payer: Multiplan Commercial |
$2,690.25
|
|
|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$3,587.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.66 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$717.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,464.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,331.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,220.35
|
| Rate for Payer: Heritage Provider Network Senior |
$2,491.60
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$590.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,848.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$649.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$896.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$2,690.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,228.26
|
| Rate for Payer: TriValley Medical Group Senior |
$2,228.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
|
OP
|
$945.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$171.04 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$189.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$505.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$649.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$425.25
|
| Rate for Payer: Cash Price |
$425.25
|
| Rate for Payer: Cash Price |
$425.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$614.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: Dignity Health Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$584.96
|
| Rate for Payer: Heritage Provider Network Senior |
$1,081.26
|
| Rate for Payer: Humana Medicare |
$879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,670.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,037.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,107.63
|
| Rate for Payer: Multiplan Commercial |
$708.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
|
IP
|
$1,784.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$322.90 |
| Max. Negotiated Rate |
$1,338.00 |
| Rate for Payer: Adventist Health Commercial |
$356.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,225.61
|
| Rate for Payer: Cash Price |
$802.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,207.77
|
| Rate for Payer: Heritage Provider Network Senior |
$1,207.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$322.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$446.00
|
| Rate for Payer: Multiplan Commercial |
$1,338.00
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
|
IP
|
$1,104.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$199.82 |
| Max. Negotiated Rate |
$828.00 |
| Rate for Payer: Adventist Health Commercial |
$220.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$758.45
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$747.41
|
| Rate for Payer: Heritage Provider Network Senior |
$747.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Multiplan Commercial |
$828.00
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
|
OP
|
$1,104.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$198.63 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$220.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$758.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$938.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$828.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$717.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$938.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$938.40
|
| Rate for Payer: Dignity Health Senior |
$938.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$683.38
|
| Rate for Payer: Heritage Provider Network Senior |
$683.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$198.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$532.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Multiplan Commercial |
$828.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$938.40
|
| Rate for Payer: Vantage Medical Group Senior |
$938.40
|
|
|
HC PARAFFIN BATH PT
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
905103109
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.80
|
| Rate for Payer: Heritage Provider Network Senior |
$117.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
|
|
HC PARAFFIN BATH PT
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
905103109
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$147.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.50
|
| 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 |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$147.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.90
|
| Rate for Payer: Dignity Health Senior |
$147.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.71
|
| Rate for Payer: Heritage Provider Network Senior |
$107.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$83.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| 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 |
$147.90
|
| Rate for Payer: Vantage Medical Group Senior |
$147.90
|
|
|
HC PARAFFIN BATH PT COMM MCARE
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
900419066
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.80
|
| Rate for Payer: Heritage Provider Network Senior |
$117.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
|
|
HC PARAFFIN BATH PT COMM MCARE
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
900419066
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$147.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.50
|
| 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 |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$147.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.90
|
| Rate for Payer: Dignity Health Senior |
$147.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.71
|
| Rate for Payer: Heritage Provider Network Senior |
$107.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$83.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| 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 |
$147.90
|
| Rate for Payer: Vantage Medical Group Senior |
$147.90
|
|
|
HC PARANASAL SINUS LTD
|
Facility
|
OP
|
$507.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.73 |
| Max. Negotiated Rate |
$380.25 |
| Rate for Payer: Adventist Health Commercial |
$101.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$49.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$348.31
|
| 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 |
$148.20
|
| 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 |
$228.15
|
| Rate for Payer: Cash Price |
$228.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$329.55
|
| 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 |
$329.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$113.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$313.83
|
| Rate for Payer: Heritage Provider Network Senior |
$313.83
|
| Rate for Payer: Humana Medicare |
$113.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.73
|
| 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 |
$91.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.75
|
| 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 |
$380.25
|
| 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 PARANASAL SINUS LTD
|
Facility
|
IP
|
$507.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.77 |
| Max. Negotiated Rate |
$380.25 |
| Rate for Payer: Adventist Health Commercial |
$101.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$348.31
|
| Rate for Payer: Cash Price |
$228.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$343.24
|
| Rate for Payer: Heritage Provider Network Senior |
$343.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.75
|
| Rate for Payer: Multiplan Commercial |
$380.25
|
|
|
HC PARASITE SCREEN
|
Facility
|
IP
|
$320.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.92 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Adventist Health Commercial |
$64.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$219.84
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$216.64
|
| Rate for Payer: Heritage Provider Network Senior |
$216.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$240.00
|
|
|
HC PARASITE SCREEN
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.33 |
| Max. Negotiated Rate |
$75.23 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.23
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Senior |
$11.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.47
|
| Rate for Payer: Heritage Provider Network Senior |
$28.47
|
| Rate for Payer: Humana Medicare |
$11.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.09
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.98
|
| Rate for Payer: TriValley Medical Group Senior |
$11.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC PARATHYROID WITH PLANAR
|
Facility
|
OP
|
$1,193.00
|
|
|
Service Code
|
CPT 78072
|
| Hospital Charge Code |
900078072
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$215.93 |
| Max. Negotiated Rate |
$1,283.13 |
| Rate for Payer: Adventist Health Commercial |
$238.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$667.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$819.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Blue Shield of California Commercial |
$740.85
|
| Rate for Payer: Blue Shield of California EPN |
$700.29
|
| Rate for Payer: Cash Price |
$536.85
|
| Rate for Payer: Cash Price |
$536.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$775.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.86
|
| Rate for Payer: Dignity Health Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$775.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$675.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$738.47
|
| Rate for Payer: Heritage Provider Network Senior |
$738.47
|
| Rate for Payer: Humana Medicare |
$675.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$569.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$675.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,283.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$850.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$850.92
|
| Rate for Payer: Multiplan Commercial |
$894.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$742.86
|
| Rate for Payer: TriValley Medical Group Senior |
$675.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC PARATHYROID WITH PLANAR
|
Facility
|
IP
|
$1,193.00
|
|
|
Service Code
|
CPT 78072
|
| Hospital Charge Code |
900078072
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$215.93 |
| Max. Negotiated Rate |
$894.75 |
| Rate for Payer: Adventist Health Commercial |
$238.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$819.59
|
| Rate for Payer: Cash Price |
$536.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$807.66
|
| Rate for Payer: Heritage Provider Network Senior |
$807.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.25
|
| Rate for Payer: Multiplan Commercial |
$894.75
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
OP
|
$41,006.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820329
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$30,754.50 |
| Rate for Payer: Adventist Health Commercial |
$8,201.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21,917.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,171.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$18,452.70
|
| Rate for Payer: Cash Price |
$18,452.70
|
| Rate for Payer: Cash Price |
$18,452.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: Dignity Health Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,653.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$195.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,382.71
|
| Rate for Payer: Heritage Provider Network Senior |
$240.06
|
| Rate for Payer: Humana Medicare |
$195.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$370.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,422.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,251.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.91
|
| Rate for Payer: Multiplan Commercial |
$30,754.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$214.69
|
| Rate for Payer: TriValley Medical Group Senior |
$195.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
IP
|
$41,006.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820329
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$30,754.50 |
| Rate for Payer: Adventist Health Commercial |
$8,201.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,171.12
|
| Rate for Payer: Cash Price |
$18,452.70
|
| Rate for Payer: Cash Price |
$18,452.70
|
| 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 |
$7,422.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,251.50
|
| Rate for Payer: Multiplan Commercial |
$30,754.50
|
|
|
HC PARTIAL AMPUTATION OF TOE
|
Facility
|
IP
|
$4,668.00
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
900501505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.91 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Adventist Health Commercial |
$933.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,206.92
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,160.24
|
| Rate for Payer: Heritage Provider Network Senior |
$3,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$844.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,167.00
|
| Rate for Payer: Multiplan Commercial |
$3,501.00
|
|
|
HC PARTIAL AMPUTATION OF TOE
|
Facility
|
OP
|
$4,668.00
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
900501505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.91 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$933.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,206.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,034.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,160.24
|
| Rate for Payer: Heritage Provider Network Senior |
$3,160.24
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,249.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$844.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,167.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: Multiplan Commercial |
$3,501.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,694.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,559.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
|
IP
|
$3,653.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$661.19 |
| Max. Negotiated Rate |
$2,739.75 |
| Rate for Payer: Adventist Health Commercial |
$730.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,509.61
|
| Rate for Payer: Cash Price |
$1,643.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,473.08
|
| Rate for Payer: Heritage Provider Network Senior |
$2,473.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$913.25
|
| Rate for Payer: Multiplan Commercial |
$2,739.75
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
|
OP
|
$3,653.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$661.19 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$730.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,509.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,643.85
|
| Rate for Payer: Cash Price |
$1,643.85
|
| Rate for Payer: Cash Price |
$1,643.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,374.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,473.08
|
| Rate for Payer: Heritage Provider Network Senior |
$2,473.08
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,760.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$913.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,739.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,326.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,220.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
|
OP
|
$7,430.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$7,436.00 |
| Rate for Payer: Adventist Health Commercial |
$1,486.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,104.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Cash Price |
$3,343.50
|
| Rate for Payer: Cash Price |
$3,343.50
|
| Rate for Payer: Cash Price |
$3,343.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,829.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: Dignity Health Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,829.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,911.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,030.11
|
| Rate for Payer: Heritage Provider Network Senior |
$5,030.11
|
| Rate for Payer: Humana Medicare |
$2,911.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,911.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,581.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,344.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,435.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,857.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,668.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,668.65
|
| Rate for Payer: Multiplan Commercial |
$5,572.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,697.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,482.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
|
IP
|
$7,430.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,344.83 |
| Max. Negotiated Rate |
$5,572.50 |
| Rate for Payer: Adventist Health Commercial |
$1,486.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,104.41
|
| Rate for Payer: Cash Price |
$3,343.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,030.11
|
| Rate for Payer: Heritage Provider Network Senior |
$5,030.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,344.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,857.50
|
| Rate for Payer: Multiplan Commercial |
$5,572.50
|
|
|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$153.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$197.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Blue Shield of California Commercial |
$178.85
|
| Rate for Payer: Blue Shield of California EPN |
$169.06
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$187.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Senior |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.27
|
| Rate for Payer: Heritage Provider Network Senior |
$178.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$138.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
