|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900910229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$97.89
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.90
|
| Rate for Payer: Heritage Provider Network Senior |
$102.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.00
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900910229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$57.15 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$93.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.15
|
| Rate for Payer: Blue Shield of California Commercial |
$48.61
|
| Rate for Payer: Blue Shield of California Commercial |
$48.61
|
| Rate for Payer: Blue Shield of California EPN |
$38.99
|
| Rate for Payer: Blue Shield of California EPN |
$38.99
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$98.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$94.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.14
|
| Rate for Payer: Heritage Provider Network Senior |
$94.09
|
| Rate for Payer: Heritage Provider Network Senior |
$37.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$72.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.09
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.04
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.04
|
| Rate for Payer: TriValley Medical Group Senior |
$6.04
|
| Rate for Payer: TriValley Medical Group Senior |
$6.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
|
|
HC LACTATE DEHYDROGENASE BODY FL
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900912243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.06
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.91
|
| Rate for Payer: Heritage Provider Network Senior |
$37.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
|
|
HC LACTATE DEHYDROGENASE BODY FL
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900912243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$57.15 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.15
|
| Rate for Payer: Blue Shield of California Commercial |
$48.61
|
| Rate for Payer: Blue Shield of California Commercial |
$48.61
|
| Rate for Payer: Blue Shield of California EPN |
$38.99
|
| Rate for Payer: Blue Shield of California EPN |
$38.99
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$36.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.86
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.66
|
| Rate for Payer: Heritage Provider Network Senior |
$33.43
|
| Rate for Payer: Heritage Provider Network Senior |
$34.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$26.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.09
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.04
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.04
|
| Rate for Payer: TriValley Medical Group Senior |
$6.04
|
| Rate for Payer: TriValley Medical Group Senior |
$6.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
900910313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.91 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Adventist Health Commercial |
$45.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$145.54
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$153.00
|
| Rate for Payer: Heritage Provider Network Senior |
$153.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.50
|
| Rate for Payer: Multiplan Commercial |
$169.50
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
900910313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.87 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Adventist Health Commercial |
$45.20
|
| Rate for Payer: Adventist Health Commercial |
$23.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$72.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$139.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.22
|
| Rate for Payer: Blue Shield of California Commercial |
$103.62
|
| Rate for Payer: Blue Shield of California Commercial |
$103.62
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$76.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$146.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$139.89
|
| Rate for Payer: Heritage Provider Network Senior |
$73.04
|
| Rate for Payer: Heritage Provider Network Senior |
$139.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$56.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$107.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$88.50
|
| Rate for Payer: Multiplan Commercial |
$169.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$82.43
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.66
|
| Rate for Payer: Heritage Provider Network Senior |
$86.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.00
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$152.24 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.81
|
| Rate for Payer: Blue Shield of California Commercial |
$152.24
|
| Rate for Payer: Blue Shield of California Commercial |
$152.24
|
| Rate for Payer: Blue Shield of California EPN |
$122.11
|
| Rate for Payer: Blue Shield of California EPN |
$122.11
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$83.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$52.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.32
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$79.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.14
|
| Rate for Payer: Heritage Provider Network Senior |
$79.23
|
| Rate for Payer: Heritage Provider Network Senior |
$50.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$61.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$38.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.89
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Multiplan Commercial |
$60.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.32
|
| Rate for Payer: TriValley Medical Group Senior |
$19.32
|
| Rate for Payer: TriValley Medical Group Senior |
$19.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$19.32
|
| Rate for Payer: Vantage Medical Group Senior |
$19.32
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018224
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018424
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018224
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018124
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018124
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018424
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018126
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018226
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018426
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018426
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018226
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018126
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9160
|
| Hospital Charge Code |
900018225
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9160
|
| Hospital Charge Code |
900018225
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9160
|
| Hospital Charge Code |
900018425
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9160
|
| Hospital Charge Code |
900018425
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC LANG COMP GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9160
|
| Hospital Charge Code |
900018125
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
