|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$602.25 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$517.13
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$543.63
|
| Rate for Payer: Heritage Provider Network Senior |
$543.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$145.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$496.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$381.43
|
| Rate for Payer: Blue Shield of California EPN |
$303.53
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$521.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$171.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$543.63
|
| Rate for Payer: Heritage Provider Network Senior |
$543.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$383.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$145.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$196.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: TriValley Medical Group Commercial |
$481.80
|
| Rate for Payer: TriValley Medical Group Senior |
$481.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$14,633.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,648.57 |
| Max. Negotiated Rate |
$10,974.75 |
| Rate for Payer: Adventist Health Commercial |
$2,926.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,043.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| 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 |
$6,584.85
|
| Rate for Payer: Cash Price |
$6,584.85
|
| Rate for Payer: Cash Price |
$6,584.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,511.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,604.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,057.83
|
| Rate for Payer: Heritage Provider Network Senior |
$5,664.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8,749.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,648.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,295.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,658.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$10,974.75
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,065.49
|
| Rate for Payer: TriValley Medical Group Senior |
$5,065.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
IP
|
$14,633.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,648.57 |
| Max. Negotiated Rate |
$10,974.75 |
| Rate for Payer: Adventist Health Commercial |
$2,926.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,423.65
|
| Rate for Payer: Cash Price |
$6,584.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,906.54
|
| Rate for Payer: Heritage Provider Network Senior |
$9,906.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,648.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,658.25
|
| Rate for Payer: Multiplan Commercial |
$10,974.75
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$488.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$481.90
|
| Rate for Payer: Blue Shield of California EPN |
$385.52
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$513.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$165.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$489.01
|
| Rate for Payer: Heritage Provider Network Senior |
$489.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$376.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$182.04
|
| Rate for Payer: TriValley Medical Group Senior |
$165.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$395.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$395.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$488.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$375.25
|
| Rate for Payer: Blue Shield of California EPN |
$298.62
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$513.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$165.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$376.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
| Rate for Payer: Multiplan WC |
$316.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$474.00
|
| Rate for Payer: TriValley Medical Group Senior |
$474.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$592.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$508.76
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$142.99 |
| Max. Negotiated Rate |
$592.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$508.76
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$534.83
|
| Rate for Payer: Heritage Provider Network Senior |
$534.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.50
|
| Rate for Payer: Multiplan Commercial |
$592.50
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$12,136.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,196.62 |
| Max. Negotiated Rate |
$9,102.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,815.58
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,216.07
|
| Rate for Payer: Heritage Provider Network Senior |
$8,216.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$12,136.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,196.62 |
| Max. Negotiated Rate |
$12,185.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,500.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,674.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,102.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,888.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,315.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,315.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,512.18
|
| Rate for Payer: Heritage Provider Network Senior |
$7,512.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,788.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,196.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,034.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,495.20
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
| 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 |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Senior |
$10,315.60
|
|
|
HC INSJ PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
IP
|
$23,888.00
|
|
|
Service Code
|
CPT 0918T
|
| Hospital Charge Code |
906811506
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,323.73 |
| Max. Negotiated Rate |
$17,916.00 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,383.87
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,323.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
|
|
HC INSJ PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
OP
|
$23,888.00
|
|
|
Service Code
|
CPT 0918T
|
| Hospital Charge Code |
906811506
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$20,222.71 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,762.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,527.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,643.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,786.67
|
| Rate for Payer: Heritage Provider Network Senior |
$13,091.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20,222.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,323.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,240.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,707.88
|
| Rate for Payer: TriValley Medical Group Senior |
$10,643.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC INSJ PERM CCM DFIB SYS PG AND ELTRD
|
Facility
|
IP
|
$92,542.00
|
|
|
Service Code
|
CPT 0915T
|
| Hospital Charge Code |
906811503
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$69,406.50 |
| Rate for Payer: Adventist Health Commercial |
$18,508.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$59,597.05
|
| Rate for Payer: Cash Price |
$41,643.90
|
| Rate for Payer: Cash Price |
$41,643.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16,750.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,135.50
|
| Rate for Payer: Multiplan Commercial |
$69,406.50
|
|
|
HC INSJ PERM CCM DFIB SYS PG AND ELTRD
|
Facility
|
OP
|
$92,542.00
|
|
|
Service Code
|
CPT 0915T
|
| Hospital Charge Code |
906811503
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$76,705.51 |
| Rate for Payer: Adventist Health Commercial |
$18,508.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$57,190.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,371.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| 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 |
$41,643.90
|
| Rate for Payer: Cash Price |
$41,643.90
|
| Rate for Payer: Cash Price |
$41,643.90
|
| Rate for Payer: Cash Price |
$41,643.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$60,152.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,408.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,371.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,371.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$57,283.50
|
| Rate for Payer: Heritage Provider Network Senior |
$49,656.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,371.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$76,705.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16,750.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46,427.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23,135.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54,097.57
|
| Rate for Payer: Multiplan Commercial |
$69,406.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,408.45
|
| Rate for Payer: TriValley Medical Group Senior |
$40,371.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Vantage Medical Group Senior |
$40,371.32
|
|
|
HC INSJ PERM CCM DFIB SYS PULSE GEN ONLY
|
Facility
|
IP
|
$64,789.00
|
|
|
Service Code
|
CPT 0916T
|
| Hospital Charge Code |
906811504
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$48,591.75 |
| Rate for Payer: Adventist Health Commercial |
$12,957.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41,724.12
|
| Rate for Payer: Cash Price |
$29,155.05
|
| Rate for Payer: Cash Price |
$29,155.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,726.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,197.25
|
| Rate for Payer: Multiplan Commercial |
$48,591.75
|
|
|
HC INSJ PERM CCM DFIB SYS PULSE GEN ONLY
|
Facility
|
OP
|
$64,789.00
|
|
|
Service Code
|
CPT 0916T
|
| Hospital Charge Code |
906811504
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$54,357.02 |
| Rate for Payer: Adventist Health Commercial |
$12,957.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,039.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,608.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| 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 |
$29,155.05
|
| Rate for Payer: Cash Price |
$29,155.05
|
| Rate for Payer: Cash Price |
$29,155.05
|
| Rate for Payer: Cash Price |
$29,155.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42,112.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,469.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,608.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$28,608.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$40,104.39
|
| Rate for Payer: Heritage Provider Network Senior |
$35,189.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,608.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$54,357.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,726.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32,900.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,197.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$38,336.01
|
| Rate for Payer: Multiplan Commercial |
$48,591.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$31,469.86
|
| Rate for Payer: TriValley Medical Group Senior |
$28,608.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,913.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,469.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28,608.96
|
|
|
HC INSJ PERM CCM DFIB SYS SINGLE LEAD
|
Facility
|
IP
|
$23,888.00
|
|
|
Service Code
|
CPT 0917T
|
| Hospital Charge Code |
906811505
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,323.73 |
| Max. Negotiated Rate |
$17,916.00 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,383.87
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,323.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
|
|
HC INSJ PERM CCM DFIB SYS SINGLE LEAD
|
Facility
|
OP
|
$23,888.00
|
|
|
Service Code
|
CPT 0917T
|
| Hospital Charge Code |
906811505
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$20,222.71 |
| Rate for Payer: Adventist Health Commercial |
$4,777.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,762.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cash Price |
$10,749.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,527.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,643.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,786.67
|
| Rate for Payer: Heritage Provider Network Senior |
$13,091.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20,222.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,323.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,240.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,972.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$17,916.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,707.88
|
| Rate for Payer: TriValley Medical Group Senior |
$10,643.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,205.67 |
| Max. Negotiated Rate |
$9,139.50 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,847.78
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,249.92
|
| Rate for Payer: Heritage Provider Network Senior |
$8,249.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,205.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,046.50
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,205.67 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,530.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| 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 |
$5,483.70
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,920.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,156.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,543.13
|
| Rate for Payer: Heritage Provider Network Senior |
$8,802.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,598.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,205.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,230.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,046.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,872.55
|
| Rate for Payer: TriValley Medical Group Senior |
$7,872.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
IP
|
$13,679.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,475.90 |
| Max. Negotiated Rate |
$10,259.25 |
| Rate for Payer: Adventist Health Commercial |
$2,735.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,809.28
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,260.68
|
| Rate for Payer: Heritage Provider Network Senior |
$9,260.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,475.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,419.75
|
| Rate for Payer: Multiplan Commercial |
$10,259.25
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
OP
|
$13,679.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,475.90 |
| Max. Negotiated Rate |
$10,259.25 |
| Rate for Payer: Adventist Health Commercial |
$2,735.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,453.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$6,155.55
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,891.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,467.30
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,475.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,419.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$10,259.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
OP
|
$13,679.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,475.90 |
| Max. Negotiated Rate |
$10,259.25 |
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Adventist Health Commercial |
$2,735.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,453.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,497.52
|
| Rate for Payer: Blue Shield of California EPN |
$5,170.66
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,891.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,260.68
|
| Rate for Payer: Heritage Provider Network Senior |
$9,260.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$6,524.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,475.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,419.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$10,259.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,207.40
|
| Rate for Payer: TriValley Medical Group Senior |
$8,207.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
IP
|
$13,679.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,475.90 |
| Max. Negotiated Rate |
$10,259.25 |
| Rate for Payer: Adventist Health Commercial |
$2,735.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,809.28
|
| Rate for Payer: Cash Price |
$6,155.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,260.68
|
| Rate for Payer: Heritage Provider Network Senior |
$9,260.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,475.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,419.75
|
| Rate for Payer: Multiplan Commercial |
$10,259.25
|
|
|
HC INS STABL DEV WO DCMPRN
|
Facility
|
IP
|
$78,413.00
|
|
|
Service Code
|
CPT 22869
|
| Hospital Charge Code |
900102190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,192.75 |
| Max. Negotiated Rate |
$58,809.75 |
| Rate for Payer: Adventist Health Commercial |
$15,682.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50,497.97
|
| Rate for Payer: Cash Price |
$35,285.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$53,085.60
|
| Rate for Payer: Heritage Provider Network Senior |
$53,085.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,192.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,603.25
|
| Rate for Payer: Multiplan Commercial |
$58,809.75
|
|
