|
HC PROTHROMBIN TIME QUICK
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
900910040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$32.97 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.97
|
| Rate for Payer: Blue Shield of California Commercial |
$30.69
|
| Rate for Payer: Blue Shield of California EPN |
$23.99
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.72
|
| Rate for Payer: Dignity Health Senior |
$4.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.29
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.05
|
| Rate for Payer: Heritage Provider Network Senior |
$8.05
|
| Rate for Payer: Humana Medicare |
$4.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.41
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.29
|
| Rate for Payer: TriValley Medical Group Senior |
$4.29
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.72
|
| Rate for Payer: Vantage Medical Group Senior |
$4.29
|
|
|
HC PROTHROMBIN TIME QUICK
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
900910040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.94
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.66
|
| Rate for Payer: Heritage Provider Network Senior |
$86.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.00
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
|
|
HC PROVOCHOLINE CHALLENGE
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
900801006
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$74.99 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Adventist Health Commercial |
$286.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$74.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$982.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Blue Shield of California Commercial |
$563.11
|
| Rate for Payer: Blue Shield of California EPN |
$320.23
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$929.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: Dignity Health Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$929.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$392.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$885.17
|
| Rate for Payer: Heritage Provider Network Senior |
$885.17
|
| Rate for Payer: Humana Medicare |
$392.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$745.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$462.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$494.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$494.13
|
| Rate for Payer: Multiplan Commercial |
$1,072.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$431.39
|
| Rate for Payer: TriValley Medical Group Senior |
$392.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC PROVOCHOLINE CHALLENGE
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
900801006
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$258.83 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Adventist Health Commercial |
$286.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$982.41
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$968.11
|
| Rate for Payer: Heritage Provider Network Senior |
$968.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.50
|
| Rate for Payer: Multiplan Commercial |
$1,072.50
|
|
|
HC PSEUDOANEURYSM INJECT TRT
|
Facility
|
IP
|
$707.00
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
909081388
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.97 |
| Max. Negotiated Rate |
$530.25 |
| Rate for Payer: Adventist Health Commercial |
$141.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$485.71
|
| Rate for Payer: Cash Price |
$318.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$478.64
|
| Rate for Payer: Heritage Provider Network Senior |
$478.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.75
|
| Rate for Payer: Multiplan Commercial |
$530.25
|
|
|
HC PSEUDOANEURYSM INJECT TRT
|
Facility
|
OP
|
$707.00
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
909081388
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.97 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$141.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$485.71
|
| 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 |
$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 |
$318.15
|
| Rate for Payer: Cash Price |
$318.15
|
| Rate for Payer: Cash Price |
$318.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$459.55
|
| 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 |
$437.63
|
| Rate for Payer: Heritage Provider Network Senior |
$965.43
|
| Rate for Payer: Humana Medicare |
$784.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$243.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,491.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$926.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.75
|
| 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 |
$530.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$863.39
|
| Rate for Payer: TriValley Medical Group Senior |
$863.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC PTA FEM/POP
|
Facility
|
IP
|
$16,120.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
906820148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,917.72 |
| Max. Negotiated Rate |
$12,090.00 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,913.24
|
| Rate for Payer: Heritage Provider Network Senior |
$10,913.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
|
|
HC PTA FEM/POP
|
Facility
|
OP
|
$14,338.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
909020065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$607.60 |
| Max. Negotiated Rate |
$13,568.56 |
| Rate for Payer: Adventist Health Commercial |
$2,867.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,850.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$6,452.10
|
| Rate for Payer: Cash Price |
$6,452.10
|
| Rate for Payer: Cash Price |
$6,452.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,319.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: Dignity Health Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,141.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,875.22
|
| Rate for Payer: Heritage Provider Network Senior |
$8,783.86
|
| Rate for Payer: Humana Medicare |
$7,141.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$607.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,568.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,595.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,426.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,584.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,998.10
|
| Rate for Payer: Multiplan Commercial |
$10,753.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,855.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7,855.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC PTA FEM/POP
|
Facility
|
OP
|
$16,120.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
906820148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$607.60 |
| Max. Negotiated Rate |
$13,568.56 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,478.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: Dignity Health Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,141.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,978.28
|
| Rate for Payer: Heritage Provider Network Senior |
$8,783.86
|
| Rate for Payer: Humana Medicare |
$7,141.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$607.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,568.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,426.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,998.10
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,855.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7,855.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC PTA FEM/POP
|
Facility
|
IP
|
$14,338.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
909020065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,595.18 |
| Max. Negotiated Rate |
$10,753.50 |
| Rate for Payer: Adventist Health Commercial |
$2,867.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,850.21
|
| Rate for Payer: Cash Price |
$6,452.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,706.83
|
| Rate for Payer: Heritage Provider Network Senior |
$9,706.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,595.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,584.50
|
| Rate for Payer: Multiplan Commercial |
$10,753.50
|
|
|
HC PTA ILIAC
|
Facility
|
OP
|
$16,120.00
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
906820144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$551.27 |
| Max. Negotiated Rate |
$13,568.56 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,478.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: Dignity Health Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,141.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,978.28
|
| Rate for Payer: Heritage Provider Network Senior |
$8,783.86
|
| Rate for Payer: Humana Medicare |
$7,141.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$551.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,568.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,426.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,998.10
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,855.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7,855.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC PTA ILIAC
|
Facility
|
IP
|
$21,052.00
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
909020061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,810.41 |
| Max. Negotiated Rate |
$15,789.00 |
| Rate for Payer: Adventist Health Commercial |
$4,210.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,462.72
|
| Rate for Payer: Cash Price |
$9,473.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,252.20
|
| Rate for Payer: Heritage Provider Network Senior |
$14,252.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,810.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,263.00
|
| Rate for Payer: Multiplan Commercial |
$15,789.00
|
|
|
HC PTA ILIAC
|
Facility
|
IP
|
$16,120.00
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
906820144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,917.72 |
| Max. Negotiated Rate |
$12,090.00 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,913.24
|
| Rate for Payer: Heritage Provider Network Senior |
$10,913.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
|
|
HC PTA ILIAC
|
Facility
|
OP
|
$21,052.00
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
909020061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$551.27 |
| Max. Negotiated Rate |
$15,789.00 |
| Rate for Payer: Adventist Health Commercial |
$4,210.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,462.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$9,473.40
|
| Rate for Payer: Cash Price |
$9,473.40
|
| Rate for Payer: Cash Price |
$9,473.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,683.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: Dignity Health Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,141.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,031.19
|
| Rate for Payer: Heritage Provider Network Senior |
$8,783.86
|
| Rate for Payer: Humana Medicare |
$7,141.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$551.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,568.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,810.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,426.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,263.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,998.10
|
| Rate for Payer: Multiplan Commercial |
$15,789.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,855.48
|
| Rate for Payer: TriValley Medical Group Senior |
$7,855.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC PTA ILIAC EA ADDL
|
Facility
|
OP
|
$14,033.00
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
909020063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.08 |
| Max. Negotiated Rate |
$13,479.00 |
| Rate for Payer: Adventist Health Commercial |
$2,806.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,640.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,928.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,718.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,524.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$6,314.85
|
| Rate for Payer: Cash Price |
$6,314.85
|
| Rate for Payer: Cash Price |
$6,314.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,121.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,928.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,928.05
|
| Rate for Payer: Dignity Health Senior |
$11,928.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,686.43
|
| Rate for Payer: Heritage Provider Network Senior |
$8,686.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,763.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,539.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,508.25
|
| Rate for Payer: Multiplan Commercial |
$10,524.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,928.05
|
| Rate for Payer: Vantage Medical Group Senior |
$11,928.05
|
|
|
HC PTA ILIAC EA ADDL
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
906820146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.08 |
| Max. Negotiated Rate |
$13,479.00 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,520.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,422.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,485.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,954.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,016.90
|
| Rate for Payer: Dignity Health Senior |
$13,016.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,479.37
|
| Rate for Payer: Heritage Provider Network Senior |
$9,479.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,381.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,771.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.50
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,016.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13,016.90
|
|
|
HC PTA ILIAC EA ADDL
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
906820146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,771.83 |
| Max. Negotiated Rate |
$11,485.50 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,520.72
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,367.58
|
| Rate for Payer: Heritage Provider Network Senior |
$10,367.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,771.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.50
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
|
|
HC PTA ILIAC EA ADDL
|
Facility
|
IP
|
$14,033.00
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
909020063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,539.97 |
| Max. Negotiated Rate |
$10,524.75 |
| Rate for Payer: Adventist Health Commercial |
$2,806.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,640.67
|
| Rate for Payer: Cash Price |
$6,314.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,500.34
|
| Rate for Payer: Heritage Provider Network Senior |
$9,500.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,539.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,508.25
|
| Rate for Payer: Multiplan Commercial |
$10,524.75
|
|
|
HC PTA INTRACRAN VASO EA ADD DIFF
|
Facility
|
IP
|
$7,192.00
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
909081017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,301.75 |
| Max. Negotiated Rate |
$5,394.00 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,940.90
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,868.98
|
| Rate for Payer: Heritage Provider Network Senior |
$4,868.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,301.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,798.00
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
|
|
HC PTA INTRACRAN VASO EA ADD DIFF
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
909081017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,301.75 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,940.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,955.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,394.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,674.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,113.20
|
| Rate for Payer: Dignity Health Senior |
$6,113.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,315.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,451.85
|
| Rate for Payer: Heritage Provider Network Senior |
$4,451.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,466.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,301.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,798.00
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,113.20
|
| Rate for Payer: Vantage Medical Group Senior |
$6,113.20
|
|
|
HC PTA INTRACRAN VASOPAMS EA ADDL
|
Facility
|
IP
|
$8,271.00
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
909081016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,497.05 |
| Max. Negotiated Rate |
$6,203.25 |
| Rate for Payer: Adventist Health Commercial |
$1,654.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,682.18
|
| Rate for Payer: Cash Price |
$3,721.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,599.47
|
| Rate for Payer: Heritage Provider Network Senior |
$5,599.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,497.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,067.75
|
| Rate for Payer: Multiplan Commercial |
$6,203.25
|
|
|
HC PTA INTRACRAN VASOPAMS EA ADDL
|
Facility
|
OP
|
$8,271.00
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
909081016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,497.05 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,654.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,682.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,030.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,549.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,203.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$3,721.95
|
| Rate for Payer: Cash Price |
$3,721.95
|
| Rate for Payer: Cash Price |
$3,721.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,376.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,030.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,030.35
|
| Rate for Payer: Dignity Health Senior |
$7,030.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,962.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,119.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,119.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,986.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,497.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,067.75
|
| Rate for Payer: Multiplan Commercial |
$6,203.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,030.35
|
| Rate for Payer: Vantage Medical Group Senior |
$7,030.35
|
|
|
HC PTA INTRACRAN VASOSPASM
|
Facility
|
OP
|
$24,765.00
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
909081015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,841.00 |
| Max. Negotiated Rate |
$21,050.25 |
| Rate for Payer: Adventist Health Commercial |
$4,953.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,013.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,050.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,620.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,573.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$11,144.25
|
| Rate for Payer: Cash Price |
$11,144.25
|
| Rate for Payer: Cash Price |
$11,144.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,097.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,050.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,050.25
|
| Rate for Payer: Dignity Health Senior |
$21,050.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,859.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,329.54
|
| Rate for Payer: Heritage Provider Network Senior |
$15,329.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,936.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,482.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,191.25
|
| Rate for Payer: Multiplan Commercial |
$18,573.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,050.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21,050.25
|
|
|
HC PTA INTRACRAN VASOSPASM
|
Facility
|
IP
|
$24,765.00
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
909081015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,482.46 |
| Max. Negotiated Rate |
$18,573.75 |
| Rate for Payer: Adventist Health Commercial |
$4,953.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,013.56
|
| Rate for Payer: Cash Price |
$11,144.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,765.90
|
| Rate for Payer: Heritage Provider Network Senior |
$16,765.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,482.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,191.25
|
| Rate for Payer: Multiplan Commercial |
$18,573.75
|
|
|
HC PTA TIBIOPERONEAL
|
Facility
|
OP
|
$14,630.00
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
909020069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.39 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$2,926.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,050.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$6,583.50
|
| Rate for Payer: Cash Price |
$6,583.50
|
| Rate for Payer: Cash Price |
$6,583.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,509.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,055.97
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$741.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,657.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$10,972.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
