|
HC HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$453.00
|
|
|
Service Code
|
CPT 58340
|
| Hospital Charge Code |
909000176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.99 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$90.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$279.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$249.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$339.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 |
$203.85
|
| Rate for Payer: Cash Price |
$203.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$294.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$385.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$385.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$280.41
|
| Rate for Payer: Heritage Provider Network Senior |
$280.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$216.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$317.10
|
| Rate for Payer: Multiplan Commercial |
$339.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$385.05
|
| Rate for Payer: Vantage Medical Group Senior |
$385.05
|
|
|
HC HYSTEROSALPINGOGRAM EXAM
|
Facility
|
OP
|
$1,957.00
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
909001930
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.91 |
| Max. Negotiated Rate |
$1,467.75 |
| Rate for Payer: Adventist Health Commercial |
$391.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,209.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$352.08
|
| Rate for Payer: Blue Shield of California Commercial |
$274.70
|
| Rate for Payer: Blue Shield of California EPN |
$220.91
|
| Rate for Payer: Cash Price |
$880.65
|
| Rate for Payer: Cash Price |
$880.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,272.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,154.63
|
| Rate for Payer: EPIC Health Plan Medicare |
$306.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,211.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,211.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$933.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$354.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,467.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$306.88
|
| Rate for Payer: TriValley Medical Group Senior |
$306.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$378.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$378.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC HYSTEROSALPINGOGRAM EXAM
|
Facility
|
IP
|
$1,957.00
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
909001930
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$354.22 |
| Max. Negotiated Rate |
$1,467.75 |
| Rate for Payer: Adventist Health Commercial |
$391.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,260.31
|
| Rate for Payer: Cash Price |
$880.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,324.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1,324.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$354.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.25
|
| Rate for Payer: Multiplan Commercial |
$1,467.75
|
|
|
HC I-111 OXINE PER .5 MCI
|
Facility
|
IP
|
$1,468.00
|
|
|
Service Code
|
CPT A9547
|
| Hospital Charge Code |
909301529
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$265.71 |
| Max. Negotiated Rate |
$1,101.00 |
| Rate for Payer: Adventist Health Commercial |
$293.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$945.39
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$675.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$679.68
|
| Rate for Payer: Heritage Provider Network Senior |
$679.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$265.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.00
|
| Rate for Payer: Multiplan Commercial |
$1,101.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$530.39
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$486.05
|
|
|
HC I-111 OXINE PER .5 MCI
|
Facility
|
OP
|
$1,468.00
|
|
|
Service Code
|
CPT A9547
|
| Hospital Charge Code |
909301529
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$265.71 |
| Max. Negotiated Rate |
$1,114.16 |
| Rate for Payer: Adventist Health Commercial |
$293.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,039.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$914.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$654.55
|
| Rate for Payer: Blue Shield of California Commercial |
$895.48
|
| Rate for Payer: Blue Shield of California EPN |
$716.38
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$675.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,039.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$914.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$939.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$831.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$679.68
|
| Rate for Payer: Heritage Provider Network Senior |
$679.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$700.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$265.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$956.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$1,101.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$587.20
|
| Rate for Payer: TriValley Medical Group Senior |
$587.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$530.39
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$486.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,039.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$914.61
|
|
|
HC I-123 CAPSULES PER 100-999 UCI
|
Facility
|
IP
|
$370.00
|
|
|
Service Code
|
CPT A9516
|
| Hospital Charge Code |
909301511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$238.28
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
|
|
HC I-123 CAPSULES PER 100-999 UCI
|
Facility
|
OP
|
$370.00
|
|
|
Service Code
|
CPT A9516
|
| Hospital Charge Code |
909301511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$314.50 |
| Rate for Payer: Adventist Health Commercial |
$74.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138.29
|
| Rate for Payer: Blue Shield of California Commercial |
$225.70
|
| Rate for Payer: Blue Shield of California EPN |
$180.56
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$314.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.31
|
| Rate for Payer: Heritage Provider Network Senior |
$171.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$176.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$259.00
|
| Rate for Payer: Multiplan Commercial |
$277.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$148.00
|
| Rate for Payer: TriValley Medical Group Senior |
$148.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$122.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.50
|
| Rate for Payer: Vantage Medical Group Senior |
$314.50
|
|
|
HC I-125 SEED
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT A4648
|
| Hospital Charge Code |
909301514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$169.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$105.73
|
| Rate for Payer: Blue Shield of California EPN |
$105.73
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.77
|
| Rate for Payer: Heritage Provider Network Senior |
$121.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$131.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$131.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.75
|
| Rate for Payer: Multiplan Commercial |
$197.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$95.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$87.08
|
|
|
HC I-125 SEED
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT A4648
|
| Hospital Charge Code |
909301514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$162.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$144.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$197.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$105.73
|
| Rate for Payer: Blue Shield of California EPN |
$105.73
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$223.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$223.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$223.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.77
|
| Rate for Payer: Heritage Provider Network Senior |
$121.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$131.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$131.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$184.10
|
| Rate for Payer: Multiplan Commercial |
$197.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$95.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$87.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$223.55
|
| Rate for Payer: Vantage Medical Group Senior |
$223.55
|
|
|
HC I-125 SERUM ALBUMIN PER 5 UCI
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT A9532
|
| Hospital Charge Code |
909301517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.98 |
| Max. Negotiated Rate |
$703.59 |
| Rate for Payer: Adventist Health Commercial |
$87.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$703.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$515.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$469.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.98
|
| Rate for Payer: Blue Shield of California Commercial |
$267.18
|
| Rate for Payer: Blue Shield of California EPN |
$213.74
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$201.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$703.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$515.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$469.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.32
|
| Rate for Payer: EPIC Health Plan Medicare |
$469.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.79
|
| Rate for Payer: Heritage Provider Network Senior |
$202.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$469.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$208.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$539.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$628.54
|
| Rate for Payer: Multiplan Commercial |
$328.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$175.20
|
| Rate for Payer: TriValley Medical Group Senior |
$175.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$145.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$703.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$515.97
|
| Rate for Payer: Vantage Medical Group Senior |
$469.06
|
|
|
HC I-125 SERUM ALBUMIN PER 5 UCI
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT A9532
|
| Hospital Charge Code |
909301517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.28 |
| Max. Negotiated Rate |
$328.50 |
| Rate for Payer: Adventist Health Commercial |
$87.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$282.07
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$201.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.79
|
| Rate for Payer: Heritage Provider Network Senior |
$202.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.50
|
| Rate for Payer: Multiplan Commercial |
$328.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$145.02
|
|
|
HC I-131 IOBENGUANE/MIBG PER.5MCI
|
Facility
|
IP
|
$5,753.00
|
|
|
Service Code
|
CPT A9508
|
| Hospital Charge Code |
909301519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,041.29 |
| Max. Negotiated Rate |
$4,314.75 |
| Rate for Payer: Adventist Health Commercial |
$1,150.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,704.93
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,106.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,663.64
|
| Rate for Payer: Heritage Provider Network Senior |
$2,663.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,041.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.25
|
| Rate for Payer: Multiplan Commercial |
$4,314.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,078.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,904.82
|
|
|
HC I-131 IOBENGUANE/MIBG PER.5MCI
|
Facility
|
OP
|
$5,753.00
|
|
|
Service Code
|
CPT A9508
|
| Hospital Charge Code |
909301519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$953.01 |
| Max. Negotiated Rate |
$4,314.75 |
| Rate for Payer: Adventist Health Commercial |
$1,150.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,429.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,048.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$953.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,053.97
|
| Rate for Payer: Blue Shield of California Commercial |
$3,509.33
|
| Rate for Payer: Blue Shield of California EPN |
$2,807.46
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,646.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,429.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,048.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$953.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,681.92
|
| Rate for Payer: EPIC Health Plan Medicare |
$953.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,663.64
|
| Rate for Payer: Heritage Provider Network Senior |
$2,663.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$953.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,744.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,041.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,095.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,277.03
|
| Rate for Payer: Multiplan Commercial |
$4,314.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,301.20
|
| Rate for Payer: TriValley Medical Group Senior |
$2,301.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,078.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,904.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,429.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,048.31
|
| Rate for Payer: Vantage Medical Group Senior |
$953.01
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI TH
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT A9530
|
| Hospital Charge Code |
909301569
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$20.77 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$134.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.85
|
| Rate for Payer: Blue Shield of California Commercial |
$132.37
|
| Rate for Payer: Blue Shield of California EPN |
$105.90
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$141.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$134.32
|
| Rate for Payer: Heritage Provider Network Senior |
$134.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$103.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.83
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.85
|
| Rate for Payer: TriValley Medical Group Senior |
$20.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$78.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.85
|
| Rate for Payer: Vantage Medical Group Senior |
$22.85
|
|
|
HC I-131 SODIUM IODIDE SOL/MCI TH
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT A9530
|
| Hospital Charge Code |
909301569
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$139.75
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$146.91
|
| Rate for Payer: Heritage Provider Network Senior |
$146.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.25
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$78.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.85
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
OP
|
$7,408.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$9,136.00 |
| Rate for Payer: Adventist Health Commercial |
$1,481.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,578.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,296.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,074.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,556.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| 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 |
$3,333.60
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,815.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,296.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,296.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,370.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,585.55
|
| Rate for Payer: Heritage Provider Network Senior |
$4,585.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,533.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,340.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,185.60
|
| Rate for Payer: Multiplan Commercial |
$5,556.00
|
| 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 |
$6,296.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,296.80
|
|
|
HC ICD GEN & LEAD TEST @ IMPLANT
|
Facility
|
IP
|
$7,408.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
906811333
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,340.85 |
| Max. Negotiated Rate |
$5,556.00 |
| Rate for Payer: Adventist Health Commercial |
$1,481.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,770.75
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,340.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.00
|
| Rate for Payer: Multiplan Commercial |
$5,556.00
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
IP
|
$4,087.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$739.75 |
| Max. Negotiated Rate |
$3,065.25 |
| Rate for Payer: Adventist Health Commercial |
$817.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,632.03
|
| Rate for Payer: Cash Price |
$1,839.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,766.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,766.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.75
|
| Rate for Payer: Multiplan Commercial |
$3,065.25
|
|
|
HC ICD GEN &/OR LEAD REMOVE, THOR
|
Facility
|
OP
|
$4,087.00
|
|
|
Service Code
|
CPT 33243
|
| Hospital Charge Code |
906811339
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$739.75 |
| Max. Negotiated Rate |
$12,150.00 |
| Rate for Payer: Adventist Health Commercial |
$817.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,525.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,247.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,065.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| 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 |
$1,839.15
|
| Rate for Payer: Cash Price |
$1,839.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,656.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,473.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,473.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,529.85
|
| Rate for Payer: Heritage Provider Network Senior |
$2,529.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,949.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,860.90
|
| Rate for Payer: Multiplan Commercial |
$3,065.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10,259.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,473.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,473.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,473.95
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,972.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,435.00
|
| 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 |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,126.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,806.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,977.39
|
| Rate for Payer: Heritage Provider Network Senior |
$5,911.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9,132.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$870.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,527.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,286.98
|
| Rate for Payer: TriValley Medical Group Senior |
$5,286.98
|
| 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 |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC ICD GEN REMOVE ONLY
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
906811372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$3,607.50 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,097.64
|
| Rate for Payer: Cash Price |
$2,164.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,256.37
|
| Rate for Payer: Heritage Provider Network Senior |
$3,256.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$870.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
|
|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
IP
|
$81,925.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,828.42 |
| Max. Negotiated Rate |
$61,443.75 |
| Rate for Payer: Adventist Health Commercial |
$16,385.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52,759.70
|
| Rate for Payer: Cash Price |
$36,866.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$55,463.22
|
| Rate for Payer: Heritage Provider Network Senior |
$55,463.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,828.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,481.25
|
| Rate for Payer: Multiplan Commercial |
$61,443.75
|
|
|
HC ICD INSERT/REPOS SINGLE/DBL +LEAD
|
Facility
|
OP
|
$81,925.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
906811377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,103.00 |
| Max. Negotiated Rate |
$76,705.51 |
| Rate for Payer: Adventist Health Commercial |
$16,385.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50,629.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,371.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$36,866.25
|
| Rate for Payer: Cash Price |
$36,866.25
|
| Rate for Payer: Cash Price |
$36,866.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53,251.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,408.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,371.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,371.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$50,711.57
|
| Rate for Payer: Heritage Provider Network Senior |
$49,656.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,371.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$76,705.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,828.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46,427.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,481.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54,097.57
|
| Rate for Payer: Multiplan Commercial |
$61,443.75
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,408.45
|
| Rate for Payer: TriValley Medical Group Senior |
$44,408.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Vantage Medical Group Senior |
$40,371.32
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
IP
|
$53,705.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,720.60 |
| Max. Negotiated Rate |
$40,278.75 |
| Rate for Payer: Adventist Health Commercial |
$10,741.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,586.02
|
| Rate for Payer: Cash Price |
$24,167.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,358.29
|
| Rate for Payer: Heritage Provider Network Senior |
$36,358.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,720.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,426.25
|
| Rate for Payer: Multiplan Commercial |
$40,278.75
|
|
|
HC ICD INSERT SINGLE/DBL CHAMBER
|
Facility
|
OP
|
$53,705.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
906811375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,103.00 |
| Max. Negotiated Rate |
$66,017.00 |
| Rate for Payer: Adventist Health Commercial |
$10,741.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,189.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,608.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$24,167.25
|
| Rate for Payer: Cash Price |
$24,167.25
|
| Rate for Payer: Cash Price |
$24,167.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34,908.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,469.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,608.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,608.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,243.39
|
| Rate for Payer: Heritage Provider Network Senior |
$35,189.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,608.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$54,357.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,720.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32,900.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,426.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$38,336.01
|
| Rate for Payer: Multiplan Commercial |
$40,278.75
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,469.86
|
| Rate for Payer: TriValley Medical Group Senior |
$31,469.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28,608.96
|
|
