|
HC KIT NDL BIOPSY TRAY 152MM
|
Facility
|
OP
|
$89.04
|
|
|
Service Code
|
CPT C1830
|
| Hospital Charge Code |
909081706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.12 |
| Max. Negotiated Rate |
$75.68 |
| Rate for Payer: Adventist Health Commercial |
$17.81
|
| Rate for Payer: Aetna of CA Gatekeeper |
$47.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.78
|
| Rate for Payer: Blue Shield of California Commercial |
$54.31
|
| Rate for Payer: Blue Shield of California EPN |
$43.45
|
| Rate for Payer: Cash Price |
$48.97
|
| Rate for Payer: Cigna of CA HMO/PPO |
$57.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.68
|
| Rate for Payer: Dignity Health Senior |
$75.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.12
|
| Rate for Payer: Heritage Provider Network Senior |
$55.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$42.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.33
|
| Rate for Payer: Multiplan Commercial |
$66.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$44.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$44.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.68
|
| Rate for Payer: Vantage Medical Group Senior |
$75.68
|
|
|
HC KIT NDL BIOPSY TRAY 152MM
|
Facility
|
IP
|
$89.04
|
|
|
Service Code
|
CPT C1830
|
| Hospital Charge Code |
909081706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.12 |
| Max. Negotiated Rate |
$66.78 |
| Rate for Payer: Adventist Health Commercial |
$17.81
|
| Rate for Payer: Cash Price |
$48.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.28
|
| Rate for Payer: Heritage Provider Network Senior |
$60.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.26
|
| Rate for Payer: Multiplan Commercial |
$66.78
|
|
|
HC KNEE 1-2 VIEWS
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
909001621
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.81 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$316.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$407.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.32
|
| Rate for Payer: Blue Shield of California Commercial |
$107.90
|
| Rate for Payer: Blue Shield of California EPN |
$86.77
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$385.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$367.07
|
| Rate for Payer: Heritage Provider Network Senior |
$367.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$282.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| 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 |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC KNEE 1-2 VIEWS
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
909001621
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.33 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$401.46
|
| Rate for Payer: Heritage Provider Network Senior |
$401.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.25
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
|
|
HC KNEE 3 VIEWS
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
909001675
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.88 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$541.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.92
|
| Rate for Payer: Blue Shield of California Commercial |
$120.91
|
| Rate for Payer: Blue Shield of California EPN |
$97.23
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$658.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$627.05
|
| Rate for Payer: Heritage Provider Network Senior |
$627.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$483.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| 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 |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC KNEE 3 VIEWS
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
909001675
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.35 |
| Max. Negotiated Rate |
$759.75 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$685.80
|
| Rate for Payer: Heritage Provider Network Senior |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.25
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
|
|
HC KNEE COMPLETE 4 VIEWS
|
Facility
|
OP
|
$959.00
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
909001622
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.87 |
| Max. Negotiated Rate |
$719.25 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$512.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$658.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.39
|
| Rate for Payer: Blue Shield of California Commercial |
$131.04
|
| Rate for Payer: Blue Shield of California EPN |
$105.38
|
| Rate for Payer: Cash Price |
$527.45
|
| Rate for Payer: Cash Price |
$527.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$623.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$623.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$593.62
|
| Rate for Payer: Heritage Provider Network Senior |
$593.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$457.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$719.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| 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 |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC KNEE COMPLETE 4 VIEWS
|
Facility
|
IP
|
$959.00
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
909001622
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$173.58 |
| Max. Negotiated Rate |
$719.25 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Cash Price |
$527.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$649.24
|
| Rate for Payer: Heritage Provider Network Senior |
$649.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.75
|
| Rate for Payer: Multiplan Commercial |
$719.25
|
|
|
HC KNEE STANDING
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
909001624
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.81 |
| Max. Negotiated Rate |
$345.75 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$246.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$316.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.89
|
| Rate for Payer: Blue Shield of California Commercial |
$101.86
|
| Rate for Payer: Blue Shield of California EPN |
$81.91
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$299.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$299.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$285.36
|
| Rate for Payer: Heritage Provider Network Senior |
$285.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$219.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| 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 |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC KNEE STANDING
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
909001624
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$345.75 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$312.10
|
| Rate for Payer: Heritage Provider Network Senior |
$312.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.25
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
|
|
HC KO ADJ JTS CUSTOM FIT
|
Facility
|
OP
|
$1,101.00
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
905351832
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$275.25 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$451.41
|
| Rate for Payer: Aetna of CA Gatekeeper |
$528.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$756.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$935.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$605.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$825.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$442.60
|
| Rate for Payer: Blue Shield of California EPN |
$442.60
|
| Rate for Payer: Cash Price |
$605.55
|
| Rate for Payer: Cash Price |
$605.55
|
| Rate for Payer: Cash Price |
$605.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$506.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$935.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.85
|
| Rate for Payer: Dignity Health Senior |
$935.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$704.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$509.76
|
| Rate for Payer: Heritage Provider Network Senior |
$509.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$550.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$550.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$770.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$770.70
|
| Rate for Payer: Multiplan Commercial |
$825.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$397.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$364.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$935.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.85
|
| Rate for Payer: Vantage Medical Group Senior |
$935.85
|
|
|
HC KO ADJ JTS CUSTOM FIT
|
Facility
|
IP
|
$1,101.00
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
905351832
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$220.20 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$220.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$528.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$442.60
|
| Rate for Payer: Blue Shield of California EPN |
$442.60
|
| Rate for Payer: Cash Price |
$605.55
|
| Rate for Payer: Cash Price |
$605.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$506.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$509.76
|
| Rate for Payer: Heritage Provider Network Senior |
$509.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$550.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$550.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.25
|
| Rate for Payer: Multiplan Commercial |
$825.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$397.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$364.54
|
|
|
HC KRAS EXON 2
|
Facility
|
OP
|
$694.00
|
|
|
Service Code
|
CPT 81275
|
| Hospital Charge Code |
903800316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.61 |
| Max. Negotiated Rate |
$1,029.63 |
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$370.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$476.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,029.63
|
| Rate for Payer: Blue Shield of California Commercial |
$423.34
|
| Rate for Payer: Blue Shield of California EPN |
$338.67
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$451.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.57
|
| Rate for Payer: Dignity Health Senior |
$193.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$193.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.59
|
| Rate for Payer: Heritage Provider Network Senior |
$429.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$193.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$331.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$243.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$243.50
|
| Rate for Payer: Multiplan Commercial |
$520.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$193.25
|
| Rate for Payer: TriValley Medical Group Senior |
$193.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$208.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$208.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.57
|
| Rate for Payer: Vantage Medical Group Senior |
$193.25
|
|
|
HC KRAS EXON 2
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 81275
|
| Hospital Charge Code |
903800316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.61 |
| Max. Negotiated Rate |
$520.50 |
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$469.84
|
| Rate for Payer: Heritage Provider Network Senior |
$469.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.50
|
| Rate for Payer: Multiplan Commercial |
$520.50
|
|
|
HC KRAS EXON VARIANTS
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 81276
|
| Hospital Charge Code |
903800317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.61 |
| Max. Negotiated Rate |
$520.50 |
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$469.84
|
| Rate for Payer: Heritage Provider Network Senior |
$469.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.50
|
| Rate for Payer: Multiplan Commercial |
$520.50
|
|
|
HC KRAS EXON VARIANTS
|
Facility
|
OP
|
$694.00
|
|
|
Service Code
|
CPT 81276
|
| Hospital Charge Code |
903800317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.61 |
| Max. Negotiated Rate |
$1,403.81 |
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$370.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$476.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,403.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,135.81
|
| Rate for Payer: Blue Shield of California EPN |
$911.02
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Cash Price |
$381.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$451.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.57
|
| Rate for Payer: Dignity Health Senior |
$193.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$193.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.59
|
| Rate for Payer: Heritage Provider Network Senior |
$429.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$193.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$331.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$243.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$243.50
|
| Rate for Payer: Multiplan Commercial |
$520.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$193.25
|
| Rate for Payer: TriValley Medical Group Senior |
$193.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$208.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$208.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.57
|
| Rate for Payer: Vantage Medical Group Senior |
$193.25
|
|
|
HC LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
OP
|
$21,755.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820299
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$16,316.25 |
| Rate for Payer: Adventist Health Commercial |
$4,351.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11,628.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,945.68
|
| 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: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$11,965.25
|
| Rate for Payer: Cash Price |
$11,965.25
|
| Rate for Payer: Cash Price |
$11,965.25
|
| Rate for Payer: Cash Price |
$11,965.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,140.75
|
| 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 |
$14,140.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,466.34
|
| Rate for Payer: Heritage Provider Network Senior |
$244.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$377.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,937.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,438.75
|
| 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 |
$16,316.25
|
| 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 |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| 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 LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
IP
|
$21,755.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820299
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,937.66 |
| Max. Negotiated Rate |
$16,316.25 |
| Rate for Payer: Adventist Health Commercial |
$4,351.00
|
| Rate for Payer: Cash Price |
$11,965.25
|
| Rate for Payer: Cash Price |
$11,965.25
|
| 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 |
$3,937.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,438.75
|
| Rate for Payer: Multiplan Commercial |
$16,316.25
|
|
|
HC LAB REF ACANTHAMEOBA CULTURE
|
Facility
|
IP
|
$9.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
900911538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$7.12 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.43
|
| Rate for Payer: Heritage Provider Network Senior |
$6.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$7.12
|
|
|
HC LAB REF ACANTHAMEOBA CULTURE
|
Facility
|
OP
|
$9.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
900911538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$60.05 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.05
|
| Rate for Payer: Blue Shield of California Commercial |
$53.34
|
| Rate for Payer: Blue Shield of California EPN |
$42.78
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.29
|
| Rate for Payer: Dignity Health Senior |
$6.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.88
|
| Rate for Payer: Heritage Provider Network Senior |
$5.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.35
|
| Rate for Payer: Multiplan Commercial |
$7.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.63
|
| Rate for Payer: TriValley Medical Group Senior |
$6.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.29
|
| Rate for Payer: Vantage Medical Group Senior |
$6.63
|
|
|
HC LAB REF ACH RECEPTOR MODULATING ABS
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912584
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$123.36 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.36
|
| Rate for Payer: Blue Shield of California Commercial |
$108.75
|
| Rate for Payer: Blue Shield of California EPN |
$87.23
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: Dignity Health Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.18
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.40
|
| Rate for Payer: TriValley Medical Group Senior |
$18.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC LAB REF ACH RECEPTOR MODULATING ABS
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912584
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.89
|
| Rate for Payer: Heritage Provider Network Senior |
$14.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
|
|
HC LAB REF ACOMPARATIVE GENE HYBRIDIZATIO
|
Facility
|
IP
|
$1,025.00
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
900912780
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$185.53 |
| Max. Negotiated Rate |
$768.75 |
| Rate for Payer: Adventist Health Commercial |
$205.00
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$693.92
|
| Rate for Payer: Heritage Provider Network Senior |
$693.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.25
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
|
|
HC LAB REF ACOMPARATIVE GENE HYBRIDIZATIO
|
Facility
|
OP
|
$1,025.00
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
900912780
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$185.53 |
| Max. Negotiated Rate |
$2,479.11 |
| Rate for Payer: Adventist Health Commercial |
$205.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$547.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$704.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$990.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$900.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,479.11
|
| Rate for Payer: Blue Shield of California Commercial |
$625.25
|
| Rate for Payer: Blue Shield of California EPN |
$500.20
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$666.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$990.00
|
| Rate for Payer: Dignity Health Senior |
$900.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$900.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.48
|
| Rate for Payer: Heritage Provider Network Senior |
$634.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$900.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$488.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,035.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,134.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$900.00
|
| Rate for Payer: TriValley Medical Group Senior |
$900.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$972.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$972.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$990.00
|
| Rate for Payer: Vantage Medical Group Senior |
$900.00
|
|
|
HC LAB REF ADDITION KARYOTYPE
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900910745
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$229.13 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.13
|
| Rate for Payer: Blue Shield of California Commercial |
$202.00
|
| Rate for Payer: Blue Shield of California EPN |
$162.02
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: Dignity Health Senior |
$33.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$33.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.17
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$33.47
|
| Rate for Payer: TriValley Medical Group Senior |
$33.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$36.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$36.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
|
