|
HC OCC THER EVALUATION INITIAL 30MIN
|
Facility
|
OP
|
$757.00
|
|
| Hospital Charge Code |
901309050
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$643.45 |
| Rate for Payer: Adventist Health Commercial |
$310.37
|
| Rate for Payer: Aetna of CA Gatekeeper |
$404.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$520.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$643.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$416.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$492.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$643.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$643.45
|
| Rate for Payer: Dignity Health Senior |
$643.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$492.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$468.58
|
| Rate for Payer: Heritage Provider Network Senior |
$468.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$361.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$529.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.90
|
| Rate for Payer: Multiplan Commercial |
$567.75
|
| 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 |
$643.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$643.45
|
| Rate for Payer: Vantage Medical Group Senior |
$643.45
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$135.40
|
| Rate for Payer: Heritage Provider Network Senior |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$106.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$137.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.93
|
| Rate for Payer: Blue Shield of California Commercial |
$26.15
|
| Rate for Payer: Blue Shield of California EPN |
$20.97
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$130.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.82
|
| Rate for Payer: Dignity Health Senior |
$4.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$123.80
|
| Rate for Payer: Heritage Provider Network Senior |
$123.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.38
|
| Rate for Payer: TriValley Medical Group Senior |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.73
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4.38
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$72.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.01
|
| Rate for Payer: Blue Shield of California Commercial |
$26.15
|
| Rate for Payer: Blue Shield of California EPN |
$20.97
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: Dignity Health Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.56
|
| Rate for Payer: Heritage Provider Network Senior |
$83.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$64.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.32
|
| Rate for Payer: TriValley Medical Group Senior |
$5.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.43 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$91.39
|
| Rate for Payer: Heritage Provider Network Senior |
$91.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$72.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.01
|
| Rate for Payer: Blue Shield of California Commercial |
$26.15
|
| Rate for Payer: Blue Shield of California EPN |
$20.97
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: Dignity Health Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.56
|
| Rate for Payer: Heritage Provider Network Senior |
$83.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$64.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.32
|
| Rate for Payer: TriValley Medical Group Senior |
$5.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.43 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$91.39
|
| Rate for Payer: Heritage Provider Network Senior |
$91.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
|
|
HC OMNIGRAFT 2.5X2.5 DERMAL REG MATRIX
|
Facility
|
OP
|
$477.00
|
|
|
Service Code
|
CPT Q4105
|
| Hospital Charge Code |
900104050
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$405.45 |
| Rate for Payer: Adventist Health Commercial |
$95.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$254.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$327.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$405.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$262.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.75
|
| Rate for Payer: Blue Shield of California Commercial |
$290.97
|
| Rate for Payer: Blue Shield of California EPN |
$232.78
|
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$219.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$405.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$405.45
|
| Rate for Payer: Dignity Health Senior |
$405.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$220.85
|
| Rate for Payer: Heritage Provider Network Senior |
$220.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$227.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$333.90
|
| Rate for Payer: Multiplan Commercial |
$357.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$190.80
|
| Rate for Payer: TriValley Medical Group Senior |
$190.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$172.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$157.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$405.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$405.45
|
| Rate for Payer: Vantage Medical Group Senior |
$405.45
|
|
|
HC OMNIGRAFT 2.5X2.5 DERMAL REG MATRIX
|
Facility
|
IP
|
$477.00
|
|
|
Service Code
|
CPT Q4105
|
| Hospital Charge Code |
900104050
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$86.34 |
| Max. Negotiated Rate |
$357.75 |
| Rate for Payer: Adventist Health Commercial |
$95.40
|
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$219.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$220.85
|
| Rate for Payer: Heritage Provider Network Senior |
$220.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.25
|
| Rate for Payer: Multiplan Commercial |
$357.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$172.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$157.93
|
|
|
HC OMNIGRAFT 4X4 DERMAL REG MATRIX
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
CPT Q4105
|
| Hospital Charge Code |
900104051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.43 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Adventist Health Commercial |
$50.20
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$115.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.21
|
| Rate for Payer: Heritage Provider Network Senior |
$116.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.75
|
| Rate for Payer: Multiplan Commercial |
$188.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$90.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$83.11
|
|
|
HC OMNIGRAFT 4X4 DERMAL REG MATRIX
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
CPT Q4105
|
| Hospital Charge Code |
900104051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Adventist Health Commercial |
$50.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$134.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$172.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.25
|
| Rate for Payer: Blue Shield of California Commercial |
$153.11
|
| Rate for Payer: Blue Shield of California EPN |
$122.49
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Cash Price |
$138.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$115.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$213.35
|
| Rate for Payer: Dignity Health Senior |
$213.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.21
|
| Rate for Payer: Heritage Provider Network Senior |
$116.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$119.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$175.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$175.70
|
| Rate for Payer: Multiplan Commercial |
$188.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.40
|
| Rate for Payer: TriValley Medical Group Senior |
$100.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$90.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$83.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$213.35
|
| Rate for Payer: Vantage Medical Group Senior |
$213.35
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
|
IP
|
$16,864.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,052.38 |
| Max. Negotiated Rate |
$12,648.00 |
| Rate for Payer: Adventist Health Commercial |
$3,372.80
|
| Rate for Payer: Cash Price |
$9,275.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,416.93
|
| Rate for Payer: Heritage Provider Network Senior |
$11,416.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,052.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,216.00
|
| Rate for Payer: Multiplan Commercial |
$12,648.00
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
|
OP
|
$16,864.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$3,372.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,585.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,076.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$9,275.20
|
| Rate for Payer: Cash Price |
$9,275.20
|
| Rate for Payer: Cash Price |
$9,275.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,961.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.50
|
| Rate for Payer: Dignity Health Senior |
$9,076.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,076.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,416.93
|
| Rate for Payer: Heritage Provider Network Senior |
$11,416.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,044.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,052.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,216.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,436.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,436.79
|
| Rate for Payer: Multiplan Commercial |
$12,648.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6,067.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5,583.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,076.82
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
|
IP
|
$34,467.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,238.53 |
| Max. Negotiated Rate |
$25,850.25 |
| Rate for Payer: Adventist Health Commercial |
$6,893.40
|
| Rate for Payer: Cash Price |
$18,956.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,334.16
|
| Rate for Payer: Heritage Provider Network Senior |
$23,334.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,238.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,616.75
|
| Rate for Payer: Multiplan Commercial |
$25,850.25
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
|
OP
|
$34,467.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$25,850.25 |
| Rate for Payer: Adventist Health Commercial |
$6,893.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23,678.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,076.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$18,956.85
|
| Rate for Payer: Cash Price |
$18,956.85
|
| Rate for Payer: Cash Price |
$18,956.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$22,403.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.50
|
| Rate for Payer: Dignity Health Senior |
$9,076.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,076.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,334.16
|
| Rate for Payer: Heritage Provider Network Senior |
$23,334.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,440.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,238.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,616.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,436.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,436.79
|
| Rate for Payer: Multiplan Commercial |
$25,850.25
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,401.23
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,412.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,076.82
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
|
IP
|
$6,090.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,102.29 |
| Max. Negotiated Rate |
$4,567.50 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
|
OP
|
$6,090.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,183.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,958.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,904.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,191.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,016.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
|
IP
|
$6,090.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,102.29 |
| Max. Negotiated Rate |
$4,567.50 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
|
OP
|
$6,090.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,183.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,958.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,904.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,191.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,016.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC OPEN TREAT/FINGER/TOE FRACTURE
|
Facility
|
OP
|
$6,090.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
900501351
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,183.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,958.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,904.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,191.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,016.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC OPEN TREAT/FINGER/TOE FRACTURE
|
Facility
|
IP
|
$6,090.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
900501351
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,102.29 |
| Max. Negotiated Rate |
$4,567.50 |
| Rate for Payer: Adventist Health Commercial |
$1,218.00
|
| Rate for Payer: Cash Price |
$3,349.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,122.93
|
| Rate for Payer: Heritage Provider Network Senior |
$4,122.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,102.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.50
|
| Rate for Payer: Multiplan Commercial |
$4,567.50
|
|
|
HC OPEN TREAT INTERPHALANGEAL DIS
|
Facility
|
OP
|
$6,419.00
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
900501654
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,283.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,409.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$3,530.45
|
| Rate for Payer: Cash Price |
$3,530.45
|
| Rate for Payer: Cash Price |
$3,530.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,172.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,345.66
|
| Rate for Payer: Heritage Provider Network Senior |
$4,345.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,061.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,161.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$4,814.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,309.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,125.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC OPEN TREAT INTERPHALANGEAL DIS
|
Facility
|
IP
|
$6,419.00
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
900501654
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,161.84 |
| Max. Negotiated Rate |
$4,814.25 |
| Rate for Payer: Adventist Health Commercial |
$1,283.80
|
| Rate for Payer: Cash Price |
$3,530.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,345.66
|
| Rate for Payer: Heritage Provider Network Senior |
$4,345.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,161.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.75
|
| Rate for Payer: Multiplan Commercial |
$4,814.25
|
|
|
HC OPEN TREAT MANDIBULAR FX W/INT
|
Facility
|
IP
|
$14,851.00
|
|
|
Service Code
|
CPT 21462
|
| Hospital Charge Code |
900501697
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,688.03 |
| Max. Negotiated Rate |
$11,138.25 |
| Rate for Payer: Adventist Health Commercial |
$2,970.20
|
| Rate for Payer: Cash Price |
$8,168.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,054.13
|
| Rate for Payer: Heritage Provider Network Senior |
$10,054.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,688.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,712.75
|
| Rate for Payer: Multiplan Commercial |
$11,138.25
|
|
|
HC OPEN TREAT MANDIBULAR FX W/INT
|
Facility
|
OP
|
$14,851.00
|
|
|
Service Code
|
CPT 21462
|
| Hospital Charge Code |
900501697
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$11,976.10 |
| Rate for Payer: Adventist Health Commercial |
$2,970.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,202.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,516.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| Rate for Payer: Cash Price |
$8,168.05
|
| Rate for Payer: Cash Price |
$8,168.05
|
| Rate for Payer: Cash Price |
$8,168.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,653.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,268.08
|
| Rate for Payer: Dignity Health Senior |
$7,516.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,516.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,054.13
|
| Rate for Payer: Heritage Provider Network Senior |
$10,054.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,516.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,083.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,688.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,643.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,712.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,470.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,470.71
|
| Rate for Payer: Multiplan Commercial |
$11,138.25
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5,343.39
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4,917.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7,516.44
|
|
