|
HC INJ CNTRST KNEE ARTHG CT MRI
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
909000117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.56 |
| Max. Negotiated Rate |
$483.00 |
| Rate for Payer: Adventist Health Commercial |
$128.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.74
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$435.99
|
| Rate for Payer: Heritage Provider Network Senior |
$435.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$483.00
|
|
|
HC INJ CNTRST KNEE ARTHG CT MRI
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
909000117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.56 |
| Max. Negotiated Rate |
$483.00 |
| Rate for Payer: Adventist Health Commercial |
$128.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.74
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$435.99
|
| Rate for Payer: Heritage Provider Network Senior |
$435.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$483.00
|
|
|
HC INJ CNTRST KNEE ARTHG CT MRI
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
909000117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.56 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$128.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$397.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$547.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$354.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$483.00
|
| 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 |
$289.80
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$418.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$547.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$398.64
|
| Rate for Payer: Heritage Provider Network Senior |
$398.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$307.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$450.80
|
| Rate for Payer: Multiplan Commercial |
$483.00
|
| 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 |
$547.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.40
|
| Rate for Payer: Vantage Medical Group Senior |
$547.40
|
|
|
HC INJ CRV/THRC INC CATH W GUID
|
Facility
|
IP
|
$2,875.00
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
907262325
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.38 |
| Max. Negotiated Rate |
$2,156.25 |
| Rate for Payer: Adventist Health Commercial |
$575.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,851.50
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,946.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,946.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$520.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$718.75
|
| Rate for Payer: Multiplan Commercial |
$2,156.25
|
|
|
HC INJ CRV/THRC INC CATH W GUID
|
Facility
|
OP
|
$2,875.00
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
907262325
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.38 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$575.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,776.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| 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 |
$1,293.75
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,868.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,725.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,779.62
|
| Rate for Payer: Heritage Provider Network Senior |
$1,399.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,161.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$520.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$718.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$2,156.25
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Senior |
$1,251.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC INJ CRV/THRC INC CATH WO GUID
|
Facility
|
OP
|
$4,377.00
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
907262324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$792.24 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$875.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,704.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| 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 |
$1,969.65
|
| Rate for Payer: Cash Price |
$1,969.65
|
| Rate for Payer: Cash Price |
$1,969.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,845.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,626.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,709.36
|
| Rate for Payer: Heritage Provider Network Senior |
$1,399.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,161.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$792.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,094.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$3,282.75
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Senior |
$1,251.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC INJ CRV/THRC INC CATH WO GUID
|
Facility
|
IP
|
$4,377.00
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
907262324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$792.24 |
| Max. Negotiated Rate |
$3,282.75 |
| Rate for Payer: Adventist Health Commercial |
$875.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,818.79
|
| Rate for Payer: Cash Price |
$1,969.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,963.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,963.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$792.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,094.25
|
| Rate for Payer: Multiplan Commercial |
$3,282.75
|
|
|
HC INJECT ANES AGENT CELIAC PLEXUS
|
Facility
|
IP
|
$2,709.00
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
909000187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$2,031.75 |
| Rate for Payer: Adventist Health Commercial |
$541.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,744.60
|
| Rate for Payer: Cash Price |
$1,219.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,833.99
|
| Rate for Payer: Heritage Provider Network Senior |
$1,833.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$490.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$677.25
|
| Rate for Payer: Multiplan Commercial |
$2,031.75
|
|
|
HC INJECT ANES AGENT CELIAC PLEXUS
|
Facility
|
OP
|
$2,709.00
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
909000187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$541.80
|
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,129.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,674.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,219.05
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$1,219.05
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$1,219.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,187.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,760.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,096.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,625.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,130.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,676.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,399.22
|
| Rate for Payer: Heritage Provider Network Senior |
$1,399.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,161.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,161.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$490.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$456.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$677.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Multiplan Commercial |
$2,031.75
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Senior |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Senior |
$1,251.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC INJECT/ASPIRATE LIVER CYST
|
Facility
|
IP
|
$8,021.00
|
|
|
Service Code
|
CPT 47015
|
| Hospital Charge Code |
909081848
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,451.80 |
| Max. Negotiated Rate |
$6,015.75 |
| Rate for Payer: Adventist Health Commercial |
$1,604.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,165.52
|
| Rate for Payer: Cash Price |
$3,609.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,430.22
|
| Rate for Payer: Heritage Provider Network Senior |
$5,430.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,451.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,005.25
|
| Rate for Payer: Multiplan Commercial |
$6,015.75
|
|
|
HC INJECT/ASPIRATE LIVER CYST
|
Facility
|
OP
|
$8,021.00
|
|
|
Service Code
|
CPT 47015
|
| Hospital Charge Code |
909081848
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,451.80 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,604.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,956.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,817.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,411.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,015.75
|
| 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 |
$3,609.45
|
| Rate for Payer: Cash Price |
$3,609.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,213.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,817.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,817.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,817.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,965.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,965.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,826.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,451.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,005.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,614.70
|
| Rate for Payer: Multiplan Commercial |
$6,015.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,817.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,817.85
|
| Rate for Payer: Vantage Medical Group Senior |
$6,817.85
|
|
|
HC INJECT, INTRALESIONL LT 7 LSNS
|
Facility
|
IP
|
$764.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
902811900
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.28 |
| Max. Negotiated Rate |
$573.00 |
| Rate for Payer: Adventist Health Commercial |
$152.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$492.02
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$517.23
|
| Rate for Payer: Heritage Provider Network Senior |
$517.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$138.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.00
|
| Rate for Payer: Multiplan Commercial |
$573.00
|
|
|
HC INJECT, INTRALESIONL LT 7 LSNS
|
Facility
|
OP
|
$764.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
902811900
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.28 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$152.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$472.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$362.90
|
| Rate for Payer: Blue Shield of California EPN |
$288.79
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$496.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$517.23
|
| Rate for Payer: Heritage Provider Network Senior |
$517.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$364.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$138.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$573.00
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: TriValley Medical Group Commercial |
$458.40
|
| Rate for Payer: TriValley Medical Group Senior |
$458.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC INJECTION EYE DRUG
|
Facility
|
IP
|
$1,130.00
|
|
|
Service Code
|
CPT 67028
|
| Hospital Charge Code |
900501532
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.53 |
| Max. Negotiated Rate |
$847.50 |
| Rate for Payer: Adventist Health Commercial |
$226.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$727.72
|
| Rate for Payer: Cash Price |
$508.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$765.01
|
| Rate for Payer: Heritage Provider Network Senior |
$765.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.50
|
| Rate for Payer: Multiplan Commercial |
$847.50
|
|
|
HC INJECTION EYE DRUG
|
Facility
|
OP
|
$1,130.00
|
|
|
Service Code
|
CPT 67028
|
| Hospital Charge Code |
900501532
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.53 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Adventist Health Commercial |
$226.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$698.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$536.75
|
| Rate for Payer: Blue Shield of California EPN |
$427.14
|
| Rate for Payer: Cash Price |
$508.50
|
| Rate for Payer: Cash Price |
$508.50
|
| Rate for Payer: Cash Price |
$508.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$734.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$734.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$424.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$765.01
|
| Rate for Payer: Heritage Provider Network Senior |
$765.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$539.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$488.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$847.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$678.00
|
| Rate for Payer: TriValley Medical Group Senior |
$678.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC INJECTION FACIAL NERVE
|
Facility
|
OP
|
$1,291.00
|
|
|
Service Code
|
CPT 64402
|
| Hospital Charge Code |
900501174
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.67 |
| Max. Negotiated Rate |
$1,992.00 |
| Rate for Payer: Adventist Health Commercial |
$258.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$797.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,097.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$710.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$968.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$613.23
|
| Rate for Payer: Blue Shield of California EPN |
$488.00
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$839.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,097.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,097.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,097.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$839.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$874.01
|
| Rate for Payer: Heritage Provider Network Senior |
$874.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$615.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$233.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$903.70
|
| Rate for Payer: Multiplan Commercial |
$968.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$774.60
|
| Rate for Payer: TriValley Medical Group Senior |
$774.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,097.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,097.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,097.35
|
|
|
HC INJECTION FACIAL NERVE
|
Facility
|
IP
|
$1,291.00
|
|
|
Service Code
|
CPT 64402
|
| Hospital Charge Code |
900501174
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.67 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Adventist Health Commercial |
$258.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$831.40
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$874.01
|
| Rate for Payer: Heritage Provider Network Senior |
$874.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$233.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.75
|
| Rate for Payer: Multiplan Commercial |
$968.25
|
|
|
HC INJECTION OTHER PERIPHERAL NERVE
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
900501175
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$596.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$458.85
|
| Rate for Payer: Blue Shield of California EPN |
$365.15
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$627.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$907.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.98
|
| Rate for Payer: Heritage Provider Network Senior |
$653.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$460.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$579.60
|
| Rate for Payer: TriValley Medical Group Senior |
$579.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC INJECTION OTHER PERIPHERAL NERVE
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
900501175
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$622.10
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.98
|
| Rate for Payer: Heritage Provider Network Senior |
$653.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
|
|
HC INJECTION OTHER PERIPHERAL NERVE
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
900501175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$622.10
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.98
|
| Rate for Payer: Heritage Provider Network Senior |
$653.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
|
|
HC INJECTION OTHER PERIPHERAL NERVE
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
900501175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$596.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| 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 |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$627.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$907.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$597.95
|
| Rate for Payer: Heritage Provider Network Senior |
$1,116.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,724.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$998.67
|
| Rate for Payer: TriValley Medical Group Senior |
$998.67
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC INJECTION PARAVERTEBRAL JOINT
|
Facility
|
OP
|
$2,052.00
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
909000230
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$371.41 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Adventist Health Commercial |
$410.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,268.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$974.70
|
| Rate for Payer: Blue Shield of California EPN |
$775.66
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,333.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,333.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,389.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,389.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$978.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$513.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$1,539.00
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,231.20
|
| Rate for Payer: TriValley Medical Group Senior |
$1,231.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC INJECTION PARAVERTEBRAL JOINT
|
Facility
|
IP
|
$2,052.00
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
909000230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.41 |
| Max. Negotiated Rate |
$1,539.00 |
| Rate for Payer: Adventist Health Commercial |
$410.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,321.49
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,389.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,389.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$513.00
|
| Rate for Payer: Multiplan Commercial |
$1,539.00
|
|
|
HC INJECTION PARAVERTEBRAL JOINT
|
Facility
|
IP
|
$2,052.00
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
909000230
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$371.41 |
| Max. Negotiated Rate |
$1,539.00 |
| Rate for Payer: Adventist Health Commercial |
$410.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,321.49
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,389.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,389.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$513.00
|
| Rate for Payer: Multiplan Commercial |
$1,539.00
|
|
|
HC INJECTION PARAVERTEBRAL JOINT
|
Facility
|
OP
|
$2,052.00
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
909000230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.41 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$410.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,268.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| 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 |
$923.40
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Cash Price |
$923.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,333.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,231.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,137.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,270.19
|
| Rate for Payer: Heritage Provider Network Senior |
$1,399.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,161.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,308.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$513.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$1,539.00
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,251.34
|
| Rate for Payer: TriValley Medical Group Senior |
$1,251.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
