|
HC PROCALCITONIN
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.06 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Adventist Health Commercial |
$52.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$178.62
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$176.02
|
| Rate for Payer: Heritage Provider Network Senior |
$176.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.00
|
| Rate for Payer: Multiplan Commercial |
$195.00
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$155.18 |
| Rate for Payer: Adventist Health Commercial |
$20.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$77.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$70.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.30
|
| Rate for Payer: Blue Shield of California Commercial |
$155.18
|
| Rate for Payer: Blue Shield of California EPN |
$121.31
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$66.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.94
|
| Rate for Payer: Dignity Health Senior |
$27.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$27.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$63.14
|
| Rate for Payer: Heritage Provider Network Senior |
$63.14
|
| Rate for Payer: Humana Medicare |
$27.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$51.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.30
|
| Rate for Payer: Multiplan Commercial |
$76.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$27.22
|
| Rate for Payer: TriValley Medical Group Senior |
$27.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Vantage Medical Group Senior |
$27.22
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
OP
|
$9,381.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,876.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,014.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,444.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$4,221.45
|
| Rate for Payer: Cash Price |
$4,221.45
|
| Rate for Payer: Cash Price |
$4,221.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,097.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: Dignity Health Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,132.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,350.94
|
| Rate for Payer: Heritage Provider Network Senior |
$6,350.94
|
| Rate for Payer: Humana Medicare |
$1,132.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,521.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,697.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,336.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,345.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,427.06
|
| Rate for Payer: Multiplan Commercial |
$7,035.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,406.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,134.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$9,381.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,697.96 |
| Max. Negotiated Rate |
$7,035.75 |
| Rate for Payer: Adventist Health Commercial |
$1,876.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,444.75
|
| Rate for Payer: Cash Price |
$4,221.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,350.94
|
| Rate for Payer: Heritage Provider Network Senior |
$6,350.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,697.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,345.25
|
| Rate for Payer: Multiplan Commercial |
$7,035.75
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$546.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$411.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$378.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$767.72
|
| Rate for Payer: Heritage Provider Network Senior |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$205.25 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$779.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$704.21
|
| Rate for Payer: Blue Shield of California EPN |
$665.66
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$737.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$701.95
|
| Rate for Payer: Heritage Provider Network Senior |
$701.95
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$579.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$283.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$850.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$335.71
|
| Rate for Payer: TriValley Medical Group Senior |
$305.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROCEDURE ANUS
|
Facility
|
OP
|
$1,730.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.13 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$346.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,188.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,124.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: Dignity Health Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,141.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,171.21
|
| Rate for Payer: Heritage Provider Network Senior |
$1,171.21
|
| Rate for Payer: Humana Medicare |
$1,141.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$833.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,438.83
|
| Rate for Payer: Multiplan Commercial |
$1,297.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$628.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$577.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROCEDURE ANUS
|
Facility
|
IP
|
$1,730.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.13 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: Adventist Health Commercial |
$346.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,188.51
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,171.21
|
| Rate for Payer: Heritage Provider Network Senior |
$1,171.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.50
|
| Rate for Payer: Multiplan Commercial |
$1,297.50
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
OP
|
$1,254.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$226.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$250.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$670.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$861.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$564.30
|
| Rate for Payer: Cash Price |
$564.30
|
| Rate for Payer: Cash Price |
$564.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$815.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: Dignity Health Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$784.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$848.96
|
| Rate for Payer: Heritage Provider Network Senior |
$848.96
|
| Rate for Payer: Humana Medicare |
$784.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$604.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$926.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$988.97
|
| Rate for Payer: Multiplan Commercial |
$940.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$455.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$418.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
IP
|
$1,254.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$226.97 |
| Max. Negotiated Rate |
$940.50 |
| Rate for Payer: Adventist Health Commercial |
$250.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$861.50
|
| Rate for Payer: Cash Price |
$564.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$848.96
|
| Rate for Payer: Heritage Provider Network Senior |
$848.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.50
|
| Rate for Payer: Multiplan Commercial |
$940.50
|
|
|
HC PROCEDURE NOSE
|
Facility
|
IP
|
$798.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.44 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Adventist Health Commercial |
$159.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$548.23
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$540.25
|
| Rate for Payer: Heritage Provider Network Senior |
$540.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.50
|
| Rate for Payer: Multiplan Commercial |
$598.50
|
|
|
HC PROCEDURE NOSE
|
Facility
|
OP
|
$798.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.44 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$159.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$548.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$518.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$540.25
|
| Rate for Payer: Heritage Provider Network Senior |
$540.25
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$384.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$598.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$289.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$266.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
OP
|
$994.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$198.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$682.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$646.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$672.94
|
| Rate for Payer: Heritage Provider Network Senior |
$672.94
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$479.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$179.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$745.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$360.92
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$332.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
IP
|
$994.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$745.50 |
| Rate for Payer: Adventist Health Commercial |
$198.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$682.88
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$672.94
|
| Rate for Payer: Heritage Provider Network Senior |
$672.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$179.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.50
|
| Rate for Payer: Multiplan Commercial |
$745.50
|
|
|
HC PROC RECTUM
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$398.38 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,176.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,512.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,430.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: Dignity Health Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,141.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,490.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1,490.08
|
| Rate for Payer: Humana Medicare |
$1,141.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,060.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$398.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$550.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,438.83
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$799.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$735.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROC RECTUM
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$398.38 |
| Max. Negotiated Rate |
$1,650.75 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,512.09
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,490.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1,490.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$398.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$550.25
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$16.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,756.00
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: Dignity Health Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$250.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.19
|
| Rate for Payer: Heritage Provider Network Senior |
$56.19
|
| Rate for Payer: Humana Medicare |
$250.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.18
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$30.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Adventist Health Commercial |
$16.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57.02
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.19
|
| Rate for Payer: Heritage Provider Network Senior |
$56.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.75
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
OP
|
$2,048.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$153.33 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$409.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,406.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| 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 |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,331.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,267.71
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$153.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$1,536.00
|
| 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 |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
IP
|
$2,155.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$390.06 |
| Max. Negotiated Rate |
$1,616.25 |
| Rate for Payer: Adventist Health Commercial |
$431.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,480.48
|
| Rate for Payer: Cash Price |
$969.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,458.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,458.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$538.75
|
| Rate for Payer: Multiplan Commercial |
$1,616.25
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$1,830.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$331.23 |
| Max. Negotiated Rate |
$1,372.50 |
| Rate for Payer: Adventist Health Commercial |
$366.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,257.21
|
| Rate for Payer: Cash Price |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,238.91
|
| Rate for Payer: Heritage Provider Network Senior |
$1,238.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.50
|
| Rate for Payer: Multiplan Commercial |
$1,372.50
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$377.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,295.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| 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 |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,225.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,167.43
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$63.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$1,414.50
|
| 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 |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
IP
|
$8,643.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,564.38 |
| Max. Negotiated Rate |
$6,482.25 |
| Rate for Payer: Adventist Health Commercial |
$1,728.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,937.74
|
| Rate for Payer: Cash Price |
$3,889.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,851.31
|
| Rate for Payer: Heritage Provider Network Senior |
$5,851.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,564.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,160.75
|
| Rate for Payer: Multiplan Commercial |
$6,482.25
|
|
