|
HC LAY CLOS OF WND GT 30.0 CM
|
Facility
|
OP
|
$1,924.00
|
|
|
Service Code
|
CPT 12037
|
| Hospital Charge Code |
900501643
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$348.24 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$384.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,189.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,653.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$913.90
|
| Rate for Payer: Blue Shield of California EPN |
$727.27
|
| Rate for Payer: Cash Price |
$865.80
|
| Rate for Payer: Cash Price |
$865.80
|
| Rate for Payer: Cash Price |
$865.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,250.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,919.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,653.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,653.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,302.55
|
| Rate for Payer: Heritage Provider Network Senior |
$1,302.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,653.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$917.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$348.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,051.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,555.98
|
| Rate for Payer: Multiplan Commercial |
$1,443.00
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,154.40
|
| Rate for Payer: TriValley Medical Group Senior |
$1,154.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,980.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,919.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,653.72
|
|
|
HC LAY CLOS OF WND LT 2.5 CM FACE
|
Facility
|
IP
|
$854.00
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
900501035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.57 |
| Max. Negotiated Rate |
$640.50 |
| Rate for Payer: Adventist Health Commercial |
$170.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$549.98
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$578.16
|
| Rate for Payer: Heritage Provider Network Senior |
$578.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.50
|
| Rate for Payer: Multiplan Commercial |
$640.50
|
|
|
HC LAY CLOS OF WND LT 2.5 CM FACE
|
Facility
|
OP
|
$854.00
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
900501035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.57 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$170.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$527.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$405.65
|
| Rate for Payer: Blue Shield of California EPN |
$322.81
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$555.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$578.16
|
| Rate for Payer: Heritage Provider Network Senior |
$578.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$407.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$640.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$512.40
|
| Rate for Payer: TriValley Medical Group Senior |
$512.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WND LT 2.5 CM SCALP
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
900501029
|
|
Hospital Revenue Code
|
450
|
| 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 LAY CLOS OF WND LT 2.5 CM SCALP
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
900501029
|
|
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 |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| 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 |
$522.85
|
| 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 |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| 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 |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS 12.6- 20.0 CM
|
Facility
|
OP
|
$1,201.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
900501416
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$742.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$950.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$570.48
|
| Rate for Payer: Blue Shield of California EPN |
$453.98
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$780.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,045.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$950.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$950.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$950.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$572.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$217.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,093.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,273.76
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: TriValley Medical Group Commercial |
$720.60
|
| Rate for Payer: TriValley Medical Group Senior |
$720.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Vantage Medical Group Senior |
$950.57
|
|
|
HC LAY CLOS OF WNDS 12.6- 20.0 CM
|
Facility
|
IP
|
$1,201.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
900501416
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$900.75 |
| Rate for Payer: Adventist Health Commercial |
$240.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$773.44
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$813.08
|
| Rate for Payer: Heritage Provider Network Senior |
$813.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$217.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.25
|
| Rate for Payer: Multiplan Commercial |
$900.75
|
|
|
HC LAY CLOS OF WNDS 12.6-20.0 CM
|
Facility
|
IP
|
$1,672.00
|
|
|
Service Code
|
CPT 12055
|
| Hospital Charge Code |
900501039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.63 |
| Max. Negotiated Rate |
$1,254.00 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,076.77
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,131.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,131.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$302.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.00
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
|
|
HC LAY CLOS OF WNDS 12.6-20.0 CM
|
Facility
|
OP
|
$1,672.00
|
|
|
Service Code
|
CPT 12055
|
| Hospital Charge Code |
900501039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.63 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,033.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$794.20
|
| Rate for Payer: Blue Shield of California EPN |
$632.02
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,086.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,131.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,131.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$797.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$302.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,003.20
|
| Rate for Payer: TriValley Medical Group Senior |
$1,003.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS 20.1-30.0 CM
|
Facility
|
IP
|
$1,931.00
|
|
|
Service Code
|
CPT 12056
|
| Hospital Charge Code |
900501525
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$349.51 |
| Max. Negotiated Rate |
$1,448.25 |
| Rate for Payer: Adventist Health Commercial |
$386.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,243.56
|
| Rate for Payer: Cash Price |
$868.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,307.29
|
| Rate for Payer: Heritage Provider Network Senior |
$1,307.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$349.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.75
|
| Rate for Payer: Multiplan Commercial |
$1,448.25
|
|
|
HC LAY CLOS OF WNDS 20.1-30.0 CM
|
Facility
|
OP
|
$1,931.00
|
|
|
Service Code
|
CPT 12056
|
| Hospital Charge Code |
900501525
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$349.51 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$386.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,193.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$917.23
|
| Rate for Payer: Blue Shield of California EPN |
$729.92
|
| Rate for Payer: Cash Price |
$868.95
|
| Rate for Payer: Cash Price |
$868.95
|
| Rate for Payer: Cash Price |
$868.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,255.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,307.29
|
| Rate for Payer: Heritage Provider Network Senior |
$1,307.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$921.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$349.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,448.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,158.60
|
| Rate for Payer: TriValley Medical Group Senior |
$1,158.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS 2.6-5.0 CM
|
Facility
|
OP
|
$979.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
900501036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.20 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$195.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$605.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.02
|
| Rate for Payer: Blue Shield of California EPN |
$370.06
|
| Rate for Payer: Cash Price |
$440.55
|
| Rate for Payer: Cash Price |
$440.55
|
| Rate for Payer: Cash Price |
$440.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$636.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$662.78
|
| Rate for Payer: Heritage Provider Network Senior |
$662.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$466.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$734.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$587.40
|
| Rate for Payer: TriValley Medical Group Senior |
$587.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS 2.6-5.0 CM
|
Facility
|
IP
|
$979.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
900501036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.20 |
| Max. Negotiated Rate |
$734.25 |
| Rate for Payer: Adventist Health Commercial |
$195.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$630.48
|
| Rate for Payer: Cash Price |
$440.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$662.78
|
| Rate for Payer: Heritage Provider Network Senior |
$662.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.75
|
| Rate for Payer: Multiplan Commercial |
$734.25
|
|
|
HC LAY CLOS OF WNDS 2.6-7.5 CM
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
900501034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$659.25 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$566.08
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
|
|
HC LAY CLOS OF WNDS 2.6-7.5 CM
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
900501034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$543.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$417.52
|
| Rate for Payer: Blue Shield of California EPN |
$332.26
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$571.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$419.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$527.40
|
| Rate for Payer: TriValley Medical Group Senior |
$527.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS 5.1-7.5 CM
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
900501037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$199.46 |
| Max. Negotiated Rate |
$826.50 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$709.69
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$746.05
|
| Rate for Payer: Heritage Provider Network Senior |
$746.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$199.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.50
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
|
|
HC LAY CLOS OF WNDS 5.1-7.5 CM
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
900501037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$199.46 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$681.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$523.45
|
| Rate for Payer: Blue Shield of California EPN |
$416.56
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$716.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$746.05
|
| Rate for Payer: Heritage Provider Network Senior |
$746.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$525.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$199.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$661.20
|
| Rate for Payer: TriValley Medical Group Senior |
$661.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$438.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,353.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,040.25
|
| Rate for Payer: Blue Shield of California EPN |
$827.82
|
| Rate for Payer: Cash Price |
$985.50
|
| Rate for Payer: Cash Price |
$985.50
|
| Rate for Payer: Cash Price |
$985.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,423.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,482.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,482.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,044.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,642.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,314.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,314.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS GT 30.0 CM
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
900501319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$1,642.50 |
| Rate for Payer: Adventist Health Commercial |
$438.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,410.36
|
| Rate for Payer: Cash Price |
$985.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,482.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,482.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$1,642.50
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.47 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$465.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$358.15
|
| Rate for Payer: Blue Shield of California EPN |
$285.01
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$490.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$522.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$510.46
|
| Rate for Payer: Heritage Provider Network Senior |
$510.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$359.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Senior |
$452.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC LAY CLOS OF WNDS LT 2.5,NCK,HA
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
900501033
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.47 |
| Max. Negotiated Rate |
$565.50 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$485.58
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$510.46
|
| Rate for Payer: Heritage Provider Network Senior |
$510.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.50
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
|
|
HC LDCT LUNG CANCER SCREENING
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT G0297
|
| Hospital Charge Code |
909200297
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$193.20
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$711.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$203.10
|
| Rate for Payer: Heritage Provider Network Senior |
$203.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
|
|
HC LDCT LUNG CANCER SCREENING
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT G0297
|
| Hospital Charge Code |
909200297
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$910.00 |
| Rate for Payer: Adventist Health Commercial |
$60.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$185.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.06
|
| Rate for Payer: Blue Shield of California Commercial |
$183.00
|
| Rate for Payer: Blue Shield of California EPN |
$146.40
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$910.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$573.00
|
| Rate for Payer: Heritage Provider Network Senior |
$521.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$143.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$225.00
|
| Rate for Payer: TriValley Medical Group Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$150.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.00
|
| Rate for Payer: Vantage Medical Group Senior |
$255.00
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
IP
|
$42,892.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,763.45 |
| Max. Negotiated Rate |
$32,169.00 |
| Rate for Payer: Adventist Health Commercial |
$8,578.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27,622.45
|
| Rate for Payer: Cash Price |
$19,301.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,037.88
|
| Rate for Payer: Heritage Provider Network Senior |
$29,037.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,763.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,723.00
|
| Rate for Payer: Multiplan Commercial |
$32,169.00
|
|
|
HC LEAD INSERT CS, EXIST IMPL
|
Facility
|
OP
|
$42,892.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
906812214
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,103.00 |
| Max. Negotiated Rate |
$32,169.00 |
| Rate for Payer: Adventist Health Commercial |
$8,578.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,507.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,443.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$19,301.40
|
| Rate for Payer: Cash Price |
$19,301.40
|
| Rate for Payer: Cash Price |
$19,301.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27,879.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,787.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,443.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,443.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$26,550.15
|
| Rate for Payer: Heritage Provider Network Senior |
$16,534.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,443.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25,541.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,763.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,459.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,723.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,013.63
|
| Rate for Payer: Multiplan Commercial |
$32,169.00
|
| Rate for Payer: Multiplan WC |
$21,186.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$14,787.31
|
| Rate for Payer: TriValley Medical Group Senior |
$14,787.31
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,164.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,787.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13,443.01
|
|
