|
HC LUMBAR/SACRAL FACET INJECT/INT
|
Facility
|
OP
|
$2,858.00
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
909000185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$571.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,963.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,696.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,244.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,131.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$1,571.90
|
| Rate for Payer: Cash Price |
$1,571.90
|
| Rate for Payer: Cash Price |
$1,571.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,857.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,696.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,244.32
|
| Rate for Payer: Dignity Health Senior |
$1,131.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,714.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,131.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,769.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,391.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$234.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,131.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,149.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$517.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,300.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$714.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,425.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,425.31
|
| Rate for Payer: Multiplan Commercial |
$2,143.50
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,244.32
|
| Rate for Payer: TriValley Medical Group Senior |
$1,244.32
|
| 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 |
$1,696.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,244.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,131.20
|
|
|
HC LUMBAR SPINE AP AND LATERAL
|
Facility
|
IP
|
$1,214.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
909001315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$219.73 |
| Max. Negotiated Rate |
$910.50 |
| Rate for Payer: Adventist Health Commercial |
$242.80
|
| Rate for Payer: Cash Price |
$667.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$821.88
|
| Rate for Payer: Heritage Provider Network Senior |
$821.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$303.50
|
| Rate for Payer: Multiplan Commercial |
$910.50
|
|
|
HC LUMBAR SPINE AP AND LATERAL
|
Facility
|
OP
|
$1,214.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
909001315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.07 |
| Max. Negotiated Rate |
$910.50 |
| Rate for Payer: Adventist Health Commercial |
$242.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$648.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$834.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.05
|
| Rate for Payer: Blue Shield of California Commercial |
$141.12
|
| Rate for Payer: Blue Shield of California EPN |
$113.48
|
| Rate for Payer: Cash Price |
$667.70
|
| Rate for Payer: Cash Price |
$667.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$789.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$751.47
|
| Rate for Payer: Heritage Provider Network Senior |
$751.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$579.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$303.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$910.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC LUMBAR SPINE LIMITED
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
909001136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.62 |
| Max. Negotiated Rate |
$180.75 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.16
|
| Rate for Payer: Heritage Provider Network Senior |
$163.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.25
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
|
|
HC LUMBAR SPINE LIMITED
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
909001136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.62 |
| Max. Negotiated Rate |
$202.68 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$128.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$165.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.05
|
| Rate for Payer: Blue Shield of California Commercial |
$141.12
|
| Rate for Payer: Blue Shield of California EPN |
$113.48
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$156.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.18
|
| Rate for Payer: Heritage Provider Network Senior |
$149.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$114.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC LUM/SAC ABL EA ADD LEVEL
|
Facility
|
IP
|
$4,370.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
909000263
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$790.97 |
| Max. Negotiated Rate |
$3,277.50 |
| Rate for Payer: Adventist Health Commercial |
$874.00
|
| Rate for Payer: Cash Price |
$2,403.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,958.49
|
| Rate for Payer: Heritage Provider Network Senior |
$2,958.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$790.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.50
|
| Rate for Payer: Multiplan Commercial |
$3,277.50
|
|
|
HC LUM/SAC ABL EA ADD LEVEL
|
Facility
|
OP
|
$4,370.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
909000263
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$874.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,002.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,714.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,403.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,277.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$2,403.50
|
| Rate for Payer: Cash Price |
$2,403.50
|
| Rate for Payer: Cash Price |
$2,403.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,840.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,714.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,714.50
|
| Rate for Payer: Dignity Health Senior |
$3,714.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,622.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,705.03
|
| Rate for Payer: Heritage Provider Network Senior |
$2,705.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$83.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,084.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$790.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,059.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,059.00
|
| Rate for Payer: Multiplan Commercial |
$3,277.50
|
| 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 |
$3,714.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,714.50
|
| Rate for Payer: Vantage Medical Group Senior |
$3,714.50
|
|
|
HC LUM SPINE BEND ONLY/4 VIEWS
|
Facility
|
IP
|
$1,055.00
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
909001318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$190.96 |
| Max. Negotiated Rate |
$791.25 |
| Rate for Payer: Adventist Health Commercial |
$211.00
|
| Rate for Payer: Cash Price |
$580.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.24
|
| Rate for Payer: Heritage Provider Network Senior |
$714.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$190.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.75
|
| Rate for Payer: Multiplan Commercial |
$791.25
|
|
|
HC LUM SPINE BEND ONLY/4 VIEWS
|
Facility
|
OP
|
$1,055.00
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
909001318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$56.07 |
| Max. Negotiated Rate |
$791.25 |
| Rate for Payer: Adventist Health Commercial |
$211.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$563.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$724.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.13
|
| Rate for Payer: Blue Shield of California Commercial |
$188.45
|
| Rate for Payer: Blue Shield of California EPN |
$151.54
|
| Rate for Payer: Cash Price |
$580.25
|
| Rate for Payer: Cash Price |
$580.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$685.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.04
|
| Rate for Payer: Heritage Provider Network Senior |
$653.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$503.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$190.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$791.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC LUM SPINE COMP W/BENDING VIEWS
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
909001316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$85.71 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$817.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,051.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$309.10
|
| Rate for Payer: Blue Shield of California Commercial |
$249.02
|
| Rate for Payer: Blue Shield of California EPN |
$200.26
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$994.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$994.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$947.07
|
| Rate for Payer: Heritage Provider Network Senior |
$947.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$729.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC LUM SPINE COMP W/BENDING VIEWS
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
909001316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$276.93 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Cash Price |
$841.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,035.81
|
| Rate for Payer: Heritage Provider Network Senior |
$1,035.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$382.50
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
|
|
HC LUM SPINE W/OBLIQUES
|
Facility
|
IP
|
$1,010.00
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
909001317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$182.81 |
| Max. Negotiated Rate |
$757.50 |
| Rate for Payer: Adventist Health Commercial |
$202.00
|
| Rate for Payer: Cash Price |
$555.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$683.77
|
| Rate for Payer: Heritage Provider Network Senior |
$683.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.50
|
| Rate for Payer: Multiplan Commercial |
$757.50
|
|
|
HC LUM SPINE W/OBLIQUES
|
Facility
|
OP
|
$1,010.00
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
909001317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.04 |
| Max. Negotiated Rate |
$757.50 |
| Rate for Payer: Adventist Health Commercial |
$202.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$539.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$693.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239.09
|
| Rate for Payer: Blue Shield of California Commercial |
$192.48
|
| Rate for Payer: Blue Shield of California EPN |
$154.79
|
| Rate for Payer: Cash Price |
$555.50
|
| Rate for Payer: Cash Price |
$555.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$656.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$656.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$625.19
|
| Rate for Payer: Heritage Provider Network Senior |
$625.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$481.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$757.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC LUNG BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$4,488.00
|
|
|
Service Code
|
CPT 32405
|
| Hospital Charge Code |
909000124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.33 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$897.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,083.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,814.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,468.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,366.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$2,468.40
|
| Rate for Payer: Cash Price |
$2,468.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,917.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,814.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,814.80
|
| Rate for Payer: Dignity Health Senior |
$3,814.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,778.07
|
| Rate for Payer: Heritage Provider Network Senior |
$2,778.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,140.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$812.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,141.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,141.60
|
| Rate for Payer: Multiplan Commercial |
$3,366.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,244.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,244.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,814.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,814.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,814.80
|
|
|
HC LUNG BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$4,488.00
|
|
|
Service Code
|
CPT 32405
|
| Hospital Charge Code |
909000124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.33 |
| Max. Negotiated Rate |
$3,366.00 |
| Rate for Payer: Adventist Health Commercial |
$897.60
|
| Rate for Payer: Cash Price |
$2,468.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,038.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3,038.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$812.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Multiplan Commercial |
$3,366.00
|
|
|
HC LUNG DIFFER PERF & VENTILATION
|
Facility
|
OP
|
$4,060.00
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
909301402
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$439.51 |
| Max. Negotiated Rate |
$3,045.00 |
| Rate for Payer: Adventist Health Commercial |
$812.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,170.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,789.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,987.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,559.66
|
| Rate for Payer: Blue Shield of California EPN |
$1,254.23
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,639.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Senior |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,639.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$683.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,513.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,513.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$439.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,936.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$734.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$786.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$861.75
|
| Rate for Payer: Multiplan Commercial |
$3,045.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$752.32
|
| Rate for Payer: TriValley Medical Group Senior |
$683.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,030.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,030.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC LUNG DIFFER PERF & VENTILATION
|
Facility
|
IP
|
$4,060.00
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
909301402
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$734.86 |
| Max. Negotiated Rate |
$3,045.00 |
| Rate for Payer: Adventist Health Commercial |
$812.00
|
| Rate for Payer: Cash Price |
$2,233.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,748.62
|
| Rate for Payer: Heritage Provider Network Senior |
$2,748.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$734.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.00
|
| Rate for Payer: Multiplan Commercial |
$3,045.00
|
|
|
HC LUPUS SCREEN PTT
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
900912006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.01 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Adventist Health Commercial |
$36.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$98.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$126.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.82
|
| Rate for Payer: Blue Shield of California Commercial |
$48.27
|
| Rate for Payer: Blue Shield of California EPN |
$38.72
|
| Rate for Payer: Cash Price |
$101.20
|
| Rate for Payer: Cash Price |
$101.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$119.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.61
|
| Rate for Payer: Dignity Health Senior |
$6.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$113.90
|
| Rate for Payer: Heritage Provider Network Senior |
$113.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$87.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.57
|
| Rate for Payer: Multiplan Commercial |
$138.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.01
|
| Rate for Payer: TriValley Medical Group Senior |
$6.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.61
|
| Rate for Payer: Vantage Medical Group Senior |
$6.01
|
|
|
HC LUPUS SCREEN PTT
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
900912006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Adventist Health Commercial |
$36.80
|
| Rate for Payer: Cash Price |
$101.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$124.57
|
| Rate for Payer: Heritage Provider Network Senior |
$124.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.00
|
| Rate for Payer: Multiplan Commercial |
$138.00
|
|
|
HC LUTEINIZING HORMON
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
900910886
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$226.50 |
| Rate for Payer: Adventist Health Commercial |
$60.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$161.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$207.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.08
|
| Rate for Payer: Blue Shield of California Commercial |
$149.07
|
| Rate for Payer: Blue Shield of California EPN |
$119.57
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$196.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.37
|
| Rate for Payer: Dignity Health Senior |
$18.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$196.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.94
|
| Rate for Payer: Heritage Provider Network Senior |
$186.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$144.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.34
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.52
|
| Rate for Payer: TriValley Medical Group Senior |
$18.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.37
|
| Rate for Payer: Vantage Medical Group Senior |
$18.52
|
|
|
HC LUTEINIZING HORMON
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
900910886
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.66 |
| Max. Negotiated Rate |
$226.50 |
| Rate for Payer: Adventist Health Commercial |
$60.40
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$204.45
|
| Rate for Payer: Heritage Provider Network Senior |
$204.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.50
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
|
|
HC LYMPHANGIOGRAM, ABD/PLV UL
|
Facility
|
OP
|
$1,722.00
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
909001374
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.83 |
| Max. Negotiated Rate |
$5,998.81 |
| Rate for Payer: Adventist Health Commercial |
$344.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$920.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,183.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,593.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1,283.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,032.47
|
| Rate for Payer: Cash Price |
$947.10
|
| Rate for Payer: Cash Price |
$947.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,119.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,119.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,065.92
|
| Rate for Payer: Heritage Provider Network Senior |
$1,065.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$211.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$821.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$430.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$1,291.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,999.21
|
| Rate for Payer: TriValley Medical Group Senior |
$3,999.21
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$680.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$680.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LYMPHANGIOGRAM, ABD/PLV UL
|
Facility
|
IP
|
$1,722.00
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
909001374
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$311.68 |
| Max. Negotiated Rate |
$1,291.50 |
| Rate for Payer: Adventist Health Commercial |
$344.40
|
| Rate for Payer: Cash Price |
$947.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,165.79
|
| Rate for Payer: Heritage Provider Network Senior |
$1,165.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$430.50
|
| Rate for Payer: Multiplan Commercial |
$1,291.50
|
|
|
HC LYMPHANGIOGRAM EXT BILAT
|
Facility
|
IP
|
$2,426.00
|
|
|
Service Code
|
CPT 75803
|
| Hospital Charge Code |
909001373
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$439.11 |
| Max. Negotiated Rate |
$1,819.50 |
| Rate for Payer: Adventist Health Commercial |
$485.20
|
| Rate for Payer: Cash Price |
$1,334.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,642.40
|
| Rate for Payer: Heritage Provider Network Senior |
$1,642.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$606.50
|
| Rate for Payer: Multiplan Commercial |
$1,819.50
|
|
|
HC LYMPHANGIOGRAM EXT BILAT
|
Facility
|
OP
|
$2,426.00
|
|
|
Service Code
|
CPT 75803
|
| Hospital Charge Code |
909001373
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.28 |
| Max. Negotiated Rate |
$2,960.70 |
| Rate for Payer: Adventist Health Commercial |
$485.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,296.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,666.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,415.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1,140.77
|
| Rate for Payer: Blue Shield of California EPN |
$917.37
|
| Rate for Payer: Cash Price |
$1,334.30
|
| Rate for Payer: Cash Price |
$1,334.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,576.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Senior |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,576.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,973.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,501.69
|
| Rate for Payer: Heritage Provider Network Senior |
$1,501.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$210.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,157.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,269.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$606.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,486.99
|
| Rate for Payer: Multiplan Commercial |
$1,819.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,973.80
|
| Rate for Payer: TriValley Medical Group Senior |
$1,973.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$680.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$680.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
