|
HC LIGATION HEMORRHOID(S)
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$468.61 |
| Max. Negotiated Rate |
$1,941.75 |
| Rate for Payer: Adventist Health Commercial |
$517.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,667.32
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,752.75
|
| Rate for Payer: Heritage Provider Network Senior |
$1,752.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$468.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$647.25
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
|
|
HC LIGATION OF EXTREMITY ARTERY
|
Facility
|
OP
|
$4,357.00
|
|
|
Service Code
|
CPT 37618
|
| Hospital Charge Code |
900501675
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$788.62 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$871.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,692.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,396.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,267.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,069.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,646.95
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,832.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,703.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,703.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,949.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,949.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,078.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,089.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,049.90
|
| Rate for Payer: Multiplan Commercial |
$3,267.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,614.20
|
| Rate for Payer: TriValley Medical Group Senior |
$2,614.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,703.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,703.45
|
|
|
HC LIGATION OF EXTREMITY ARTERY
|
Facility
|
OP
|
$4,357.00
|
|
|
Service Code
|
CPT 37618
|
| Hospital Charge Code |
900501144
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$788.62 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$871.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,692.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,396.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,267.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,832.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,703.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,703.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,696.98
|
| Rate for Payer: Heritage Provider Network Senior |
$2,696.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,078.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,089.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,049.90
|
| Rate for Payer: Multiplan Commercial |
$3,267.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,703.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,703.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,703.45
|
|
|
HC LIGATION OF EXTREMITY ARTERY
|
Facility
|
IP
|
$4,357.00
|
|
|
Service Code
|
CPT 37618
|
| Hospital Charge Code |
900501144
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$788.62 |
| Max. Negotiated Rate |
$3,267.75 |
| Rate for Payer: Adventist Health Commercial |
$871.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,805.91
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,949.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,949.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,089.25
|
| Rate for Payer: Multiplan Commercial |
$3,267.75
|
|
|
HC LIGATION OF EXTREMITY ARTERY
|
Facility
|
IP
|
$4,357.00
|
|
|
Service Code
|
CPT 37618
|
| Hospital Charge Code |
900501675
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$788.62 |
| Max. Negotiated Rate |
$3,267.75 |
| Rate for Payer: Adventist Health Commercial |
$871.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,805.91
|
| Rate for Payer: Cash Price |
$1,960.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,949.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,949.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,089.25
|
| Rate for Payer: Multiplan Commercial |
$3,267.75
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
IP
|
$4,038.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$730.88 |
| Max. Negotiated Rate |
$3,028.50 |
| Rate for Payer: Adventist Health Commercial |
$807.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,600.47
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,733.73
|
| Rate for Payer: Heritage Provider Network Senior |
$2,733.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$730.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.50
|
| Rate for Payer: Multiplan Commercial |
$3,028.50
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
OP
|
$4,038.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$730.88 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$807.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,495.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,918.05
|
| Rate for Payer: Blue Shield of California EPN |
$1,526.36
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,624.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,733.73
|
| Rate for Payer: Heritage Provider Network Senior |
$2,733.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,926.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$730.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$3,028.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,422.80
|
| Rate for Payer: TriValley Medical Group Senior |
$2,422.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900400008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$311.05
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.99
|
| Rate for Payer: Heritage Provider Network Senior |
$326.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900400008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$410.55 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$298.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$362.25
|
| 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: Cash Price |
$217.35
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$313.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$313.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$298.98
|
| Rate for Payer: Heritage Provider Network Senior |
$298.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$230.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$338.10
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| 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 |
$410.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.55
|
| Rate for Payer: Vantage Medical Group Senior |
$410.55
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
901300023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$311.05
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.99
|
| Rate for Payer: Heritage Provider Network Senior |
$326.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
901300023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$410.55 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$298.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$362.25
|
| 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: Cash Price |
$217.35
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$313.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$313.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$298.98
|
| Rate for Payer: Heritage Provider Network Senior |
$298.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$230.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$338.10
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| 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 |
$410.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.55
|
| Rate for Payer: Vantage Medical Group Senior |
$410.55
|
|
|
HC LIMB MUSCLE TESTING MANUAL OT
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905104402
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$311.05
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.99
|
| Rate for Payer: Heritage Provider Network Senior |
$326.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
|
|
HC LIMB MUSCLE TESTING MANUAL OT
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905104402
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$410.55 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$298.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$362.25
|
| 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: Cash Price |
$217.35
|
| Rate for Payer: Cash Price |
$217.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$313.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$313.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$298.98
|
| Rate for Payer: Heritage Provider Network Senior |
$298.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$230.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$338.10
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| 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 |
$410.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.55
|
| Rate for Payer: Vantage Medical Group Senior |
$410.55
|
|
|
HC LIMB MUSCLE TESTING MANUAL PT
|
Facility
|
OP
|
$234.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905103402
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.35 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$95.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$144.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$198.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.50
|
| 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: Cash Price |
$105.30
|
| Rate for Payer: Cash Price |
$105.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$198.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$144.85
|
| Rate for Payer: Heritage Provider Network Senior |
$144.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$111.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$163.80
|
| Rate for Payer: Multiplan Commercial |
$175.50
|
| 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 |
$198.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.90
|
| Rate for Payer: Vantage Medical Group Senior |
$198.90
|
|
|
HC LIMB MUSCLE TESTING MANUAL PT
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900419057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$78.73 |
| Max. Negotiated Rate |
$326.25 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$280.14
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.50
|
| Rate for Payer: Heritage Provider Network Senior |
$294.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.75
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
|
|
HC LIMB MUSCLE TESTING MANUAL PT
|
Facility
|
IP
|
$234.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
905103402
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.35 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Adventist Health Commercial |
$46.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$150.70
|
| Rate for Payer: Cash Price |
$105.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$158.42
|
| Rate for Payer: Heritage Provider Network Senior |
$158.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.50
|
| Rate for Payer: Multiplan Commercial |
$175.50
|
|
|
HC LIMB MUSCLE TESTING MANUAL PT
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900419057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$78.73 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Adventist Health Commercial |
$178.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$268.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| 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: Cash Price |
$195.75
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$282.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$269.26
|
| Rate for Payer: Heritage Provider Network Senior |
$269.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$207.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| 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 |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC LIPASE
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.82 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Adventist Health Commercial |
$44.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$141.68
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$148.94
|
| Rate for Payer: Heritage Provider Network Senior |
$148.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.00
|
| Rate for Payer: Multiplan Commercial |
$165.00
|
|
|
HC LIPASE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Adventist Health Commercial |
$44.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$135.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$143.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$136.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.14
|
| Rate for Payer: Heritage Provider Network Senior |
$136.18
|
| Rate for Payer: Heritage Provider Network Senior |
$37.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$104.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$165.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE BODY FLUID
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| 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 |
$43.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California Commercial |
$55.41
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Blue Shield of California EPN |
$44.44
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| 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 |
$45.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.86
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.33
|
| Rate for Payer: Heritage Provider Network Senior |
$33.43
|
| Rate for Payer: Heritage Provider Network Senior |
$43.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$33.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: TriValley Medical Group Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE BODY FLUID
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.08
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.39
|
| Rate for Payer: Heritage Provider Network Senior |
$47.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
|
|
HC LIPID PANEL MC
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.34
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.79
|
| Rate for Payer: Heritage Provider Network Senior |
$29.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
|
|
HC LIPID PANEL MC
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$127.14 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.14
|
| Rate for Payer: Blue Shield of California Commercial |
$107.83
|
| Rate for Payer: Blue Shield of California EPN |
$86.49
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.96
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.24
|
| Rate for Payer: Heritage Provider Network Senior |
$27.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.94
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.39
|
| Rate for Payer: TriValley Medical Group Senior |
$13.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.39
|
|
|
HC LIQUID COILS
|
Facility
|
OP
|
$1,030.40
|
|
| Hospital Charge Code |
909081813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$636.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$772.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$414.22
|
| Rate for Payer: Blue Shield of California EPN |
$414.22
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cigna of CA HMO/PPO |
$473.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$875.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$875.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$659.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$477.08
|
| Rate for Payer: Heritage Provider Network Senior |
$477.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$515.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$515.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$721.28
|
| Rate for Payer: Multiplan Commercial |
$772.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$372.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$341.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.84
|
| Rate for Payer: Vantage Medical Group Senior |
$875.84
|
|
|
HC LIQUID COILS
|
Facility
|
IP
|
$1,030.40
|
|
| Hospital Charge Code |
909081813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$663.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$414.22
|
| Rate for Payer: Blue Shield of California EPN |
$414.22
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cigna of CA HMO/PPO |
$473.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$556.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$477.08
|
| Rate for Payer: Heritage Provider Network Senior |
$477.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$515.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$515.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$772.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$372.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$341.17
|
|
