|
HC PUNCH BX SKIN EA SEP/ADD LSN
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
900511105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Adventist Health Commercial |
$48.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$167.63
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$165.19
|
| Rate for Payer: Heritage Provider Network Senior |
$165.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.00
|
| Rate for Payer: Multiplan Commercial |
$183.00
|
|
|
HC PUNCH BX SKIN SINGLE LESION
|
Facility
|
IP
|
$487.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
900511104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.15 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Adventist Health Commercial |
$97.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$334.57
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$329.70
|
| Rate for Payer: Heritage Provider Network Senior |
$329.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
|
|
HC PUNCH BX SKIN SINGLE LESION
|
Facility
|
OP
|
$487.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
900511104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.15 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$97.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$334.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$316.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$301.45
|
| Rate for Payer: Heritage Provider Network Senior |
$612.79
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$174.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$548.02
|
| Rate for Payer: TriValley Medical Group Senior |
$548.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.18 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$398.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$377.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$359.02
|
| Rate for Payer: Heritage Provider Network Senior |
$612.79
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$73.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$548.02
|
| Rate for Payer: TriValley Medical Group Senior |
$548.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$398.46
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.66
|
| Rate for Payer: Heritage Provider Network Senior |
$392.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
906820028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$198.01 |
| Max. Negotiated Rate |
$820.50 |
| Rate for Payer: Adventist Health Commercial |
$218.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$751.58
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$740.64
|
| Rate for Payer: Heritage Provider Network Senior |
$740.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.50
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
906820028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.18 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$218.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$751.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$711.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$677.19
|
| Rate for Payer: Heritage Provider Network Senior |
$612.79
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$73.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$946.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$548.02
|
| Rate for Payer: TriValley Medical Group Senior |
$548.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$398.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$377.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: Dignity Health Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.66
|
| Rate for Payer: Heritage Provider Network Senior |
$392.66
|
| Rate for Payer: Humana Medicare |
$498.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$279.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.73
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$210.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$193.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$398.46
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.66
|
| Rate for Payer: Heritage Provider Network Senior |
$392.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$1,928.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.97 |
| Max. Negotiated Rate |
$1,446.00 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,305.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,305.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$1,928.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$348.97 |
| Max. Negotiated Rate |
$1,446.00 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,305.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,305.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$1,928.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$348.97 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,253.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: Dignity Health Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,253.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$864.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,305.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,305.26
|
| Rate for Payer: Humana Medicare |
$864.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$929.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,019.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,088.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,088.69
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$700.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$644.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$1,928.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$203.86 |
| Max. Negotiated Rate |
$3,517.28 |
| Rate for Payer: Adventist Health Commercial |
$385.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,324.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| 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 |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cash Price |
$867.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,253.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: Dignity Health Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,156.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$864.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,193.43
|
| Rate for Payer: Heritage Provider Network Senior |
$1,062.77
|
| Rate for Payer: Humana Medicare |
$864.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$203.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,641.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,019.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,088.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,088.69
|
| Rate for Payer: Multiplan Commercial |
$1,446.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$950.44
|
| Rate for Payer: TriValley Medical Group Senior |
$950.44
|
| 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 |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC PVA PARTICLES
|
Facility
|
OP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$540.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$774.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$957.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$619.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$845.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$699.87
|
| Rate for Payer: Blue Shield of California EPN |
$661.55
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$518.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$957.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$957.95
|
| Rate for Payer: Dignity Health Senior |
$957.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$721.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$521.80
|
| Rate for Payer: Heritage Provider Network Senior |
$521.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$563.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.75
|
| Rate for Payer: Multiplan Commercial |
$845.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$410.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$376.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$957.95
|
| Rate for Payer: Vantage Medical Group Senior |
$957.95
|
|
|
HC PVA PARTICLES
|
Facility
|
IP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$540.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$774.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$518.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$608.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$762.98
|
| Rate for Payer: Heritage Provider Network Senior |
$762.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$563.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.75
|
| Rate for Payer: Multiplan Commercial |
$845.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$410.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$376.53
|
|
|
HC PYRUVATE
|
Facility
|
IP
|
$253.00
|
|
|
Service Code
|
CPT 84210
|
| Hospital Charge Code |
900910251
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.79 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: Adventist Health Commercial |
$50.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$173.81
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.28
|
| Rate for Payer: Heritage Provider Network Senior |
$171.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.25
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
|
|
HC PYRUVATE
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 84210
|
| Hospital Charge Code |
900910251
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$90.89 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.89
|
| Rate for Payer: Blue Shield of California Commercial |
$84.80
|
| Rate for Payer: Blue Shield of California EPN |
$66.29
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.93
|
| Rate for Payer: Dignity Health Senior |
$14.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$25.38
|
| Rate for Payer: Heritage Provider Network Senior |
$25.38
|
| Rate for Payer: Humana Medicare |
$14.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.24
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.48
|
| Rate for Payer: TriValley Medical Group Senior |
$14.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.93
|
| Rate for Payer: Vantage Medical Group Senior |
$14.48
|
|
|
HC PYRUVATE CSF
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 84210
|
| Hospital Charge Code |
900910344
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$90.89 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.89
|
| Rate for Payer: Blue Shield of California Commercial |
$84.80
|
| Rate for Payer: Blue Shield of California EPN |
$66.29
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.93
|
| Rate for Payer: Dignity Health Senior |
$14.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$25.38
|
| Rate for Payer: Heritage Provider Network Senior |
$25.38
|
| Rate for Payer: Humana Medicare |
$14.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.24
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.48
|
| Rate for Payer: TriValley Medical Group Senior |
$14.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.93
|
| Rate for Payer: Vantage Medical Group Senior |
$14.48
|
|
|
HC PYRUVATE CSF
|
Facility
|
IP
|
$253.00
|
|
|
Service Code
|
CPT 84210
|
| Hospital Charge Code |
900910344
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.79 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: Adventist Health Commercial |
$50.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$173.81
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.28
|
| Rate for Payer: Heritage Provider Network Senior |
$171.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.25
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
|
|
HC RA223 DICLORIDE INJECTION PER MICRO CURIE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT A9606
|
| Hospital Charge Code |
909301550
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$378.42 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$378.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$241.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$177.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.25
|
| Rate for Payer: Blue Shield of California Commercial |
$242.19
|
| Rate for Payer: Blue Shield of California EPN |
$228.93
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$241.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$177.28
|
| Rate for Payer: Dignity Health Senior |
$161.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$161.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Humana Medicare |
$161.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$161.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$306.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$190.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$203.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$203.06
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$177.28
|
| Rate for Payer: TriValley Medical Group Senior |
$161.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$142.19
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$130.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$241.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$177.28
|
| Rate for Payer: Vantage Medical Group Senior |
$161.16
|
|
|
HC RA223 DICLORIDE INJECTION PER MICRO CURIE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT A9606
|
| Hospital Charge Code |
909301550
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$142.19
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$130.30
|
|
|
HC RADIATION TRT DEL COMPLEX
|
Facility
|
OP
|
$2,093.00
|
|
|
Service Code
|
CPT 77412
|
| Hospital Charge Code |
909100337
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$67.39 |
| Max. Negotiated Rate |
$1,569.75 |
| Rate for Payer: Adventist Health Commercial |
$418.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$518.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,437.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.92
|
| Rate for Payer: Blue Shield of California Commercial |
$477.14
|
| Rate for Payer: Blue Shield of California EPN |
$271.33
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,360.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.36
|
| Rate for Payer: Dignity Health Senior |
$335.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,360.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,295.57
|
| Rate for Payer: Heritage Provider Network Senior |
$1,295.57
|
| Rate for Payer: Humana Medicare |
$335.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$67.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$637.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$378.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$396.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$523.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$423.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$423.08
|
| Rate for Payer: Multiplan Commercial |
$1,569.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$285.41
|
| Rate for Payer: TriValley Medical Group Senior |
$285.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.36
|
| Rate for Payer: Vantage Medical Group Senior |
$335.78
|
|
|
HC RADIATION TRT DEL COMPLEX
|
Facility
|
IP
|
$2,093.00
|
|
|
Service Code
|
CPT 77412
|
| Hospital Charge Code |
909100337
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$378.83 |
| Max. Negotiated Rate |
$1,569.75 |
| Rate for Payer: Adventist Health Commercial |
$418.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,437.89
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,416.96
|
| Rate for Payer: Heritage Provider Network Senior |
$1,416.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$378.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$523.25
|
| Rate for Payer: Multiplan Commercial |
$1,569.75
|
|
|
HC RADIOELEMENT HANDLING/LOADING
|
Facility
|
OP
|
$1,658.00
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
909100409
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$1,409.30 |
| Rate for Payer: Adventist Health Commercial |
$331.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$85.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,139.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,409.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$911.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,243.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.58
|
| Rate for Payer: Blue Shield of California Commercial |
$100.84
|
| Rate for Payer: Blue Shield of California EPN |
$57.35
|
| Rate for Payer: Cash Price |
$746.10
|
| Rate for Payer: Cash Price |
$746.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,077.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,409.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,409.30
|
| Rate for Payer: Dignity Health Senior |
$1,409.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,077.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,026.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,026.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$799.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$300.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.50
|
| Rate for Payer: Multiplan Commercial |
$1,243.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,409.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,409.30
|
|
|
HC RADIOELEMENT HANDLING/LOADING
|
Facility
|
IP
|
$1,658.00
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
909100409
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$300.10 |
| Max. Negotiated Rate |
$1,243.50 |
| Rate for Payer: Adventist Health Commercial |
$331.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,139.05
|
| Rate for Payer: Cash Price |
$746.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,122.47
|
| Rate for Payer: Heritage Provider Network Senior |
$1,122.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$300.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.50
|
| Rate for Payer: Multiplan Commercial |
$1,243.50
|
|
