|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
IP
|
$45,368.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906820322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,211.61 |
| Max. Negotiated Rate |
$34,026.00 |
| Rate for Payer: Adventist Health Commercial |
$9,073.60
|
| Rate for Payer: Cash Price |
$24,952.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,714.14
|
| Rate for Payer: Heritage Provider Network Senior |
$30,714.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,211.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,342.00
|
| Rate for Payer: Multiplan Commercial |
$34,026.00
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
OP
|
$14,755.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$12,541.75 |
| Rate for Payer: Adventist Health Commercial |
$2,951.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,136.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,115.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,066.25
|
| 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 |
$8,115.25
|
| Rate for Payer: Cash Price |
$8,115.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9,590.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,541.75
|
| Rate for Payer: Dignity Health Senior |
$12,541.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,133.34
|
| Rate for Payer: Heritage Provider Network Senior |
$9,133.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,038.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,670.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,688.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,328.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,328.50
|
| Rate for Payer: Multiplan Commercial |
$11,066.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,541.75
|
| Rate for Payer: Vantage Medical Group Senior |
$12,541.75
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
IP
|
$14,755.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,670.66 |
| Max. Negotiated Rate |
$11,066.25 |
| Rate for Payer: Adventist Health Commercial |
$2,951.00
|
| Rate for Payer: Cash Price |
$8,115.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,989.14
|
| Rate for Payer: Heritage Provider Network Senior |
$9,989.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,670.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,688.75
|
| Rate for Payer: Multiplan Commercial |
$11,066.25
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
IP
|
$29,512.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,341.67 |
| Max. Negotiated Rate |
$22,134.00 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,979.62
|
| Rate for Payer: Heritage Provider Network Senior |
$19,979.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,341.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,378.00
|
| Rate for Payer: Multiplan Commercial |
$22,134.00
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
OP
|
$29,512.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,274.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$16,231.60
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,182.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,267.93
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,341.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,378.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$22,134.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
IP
|
$29,512.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,341.67 |
| Max. Negotiated Rate |
$22,134.00 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,979.62
|
| Rate for Payer: Heritage Provider Network Senior |
$19,979.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,341.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,378.00
|
| Rate for Payer: Multiplan Commercial |
$22,134.00
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
OP
|
$29,512.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$27,377.73 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,274.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| 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 |
$16,231.60
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Cash Price |
$16,231.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,182.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,267.93
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,341.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,378.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$22,134.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC RF ABLATION, LUNG
|
Facility
|
IP
|
$27,189.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,921.21 |
| Max. Negotiated Rate |
$20,391.75 |
| Rate for Payer: Adventist Health Commercial |
$5,437.80
|
| Rate for Payer: Cash Price |
$14,953.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,406.95
|
| Rate for Payer: Heritage Provider Network Senior |
$18,406.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,921.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,797.25
|
| Rate for Payer: Multiplan Commercial |
$20,391.75
|
|
|
HC PERC RF ABLATION, LUNG
|
Facility
|
OP
|
$27,189.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$20,391.75 |
| Rate for Payer: Adventist Health Commercial |
$5,437.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,678.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,413.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$14,953.95
|
| Rate for Payer: Cash Price |
$14,953.95
|
| Rate for Payer: Cash Price |
$14,953.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,672.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,154.45
|
| Rate for Payer: Dignity Health Senior |
$7,413.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,413.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,829.99
|
| Rate for Payer: Heritage Provider Network Senior |
$9,118.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,195.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,413.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14,084.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,921.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,525.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,797.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,340.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,340.56
|
| Rate for Payer: Multiplan Commercial |
$20,391.75
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,154.45
|
| Rate for Payer: TriValley Medical Group Senior |
$8,154.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,413.14
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
IP
|
$13,046.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,361.33 |
| Max. Negotiated Rate |
$9,784.50 |
| Rate for Payer: Adventist Health Commercial |
$2,609.20
|
| Rate for Payer: Cash Price |
$7,175.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,832.14
|
| Rate for Payer: Heritage Provider Network Senior |
$8,832.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,361.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,261.50
|
| Rate for Payer: Multiplan Commercial |
$9,784.50
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
OP
|
$13,046.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$2,609.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,962.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,413.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$7,175.30
|
| Rate for Payer: Cash Price |
$7,175.30
|
| Rate for Payer: Cash Price |
$7,175.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,479.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,154.45
|
| Rate for Payer: Dignity Health Senior |
$7,413.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,413.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,075.47
|
| Rate for Payer: Heritage Provider Network Senior |
$9,118.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,413.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14,084.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,361.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,525.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,261.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,340.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,340.56
|
| Rate for Payer: Multiplan Commercial |
$9,784.50
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,154.45
|
| Rate for Payer: TriValley Medical Group Senior |
$8,154.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,413.14
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
IP
|
$11,682.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,114.44 |
| Max. Negotiated Rate |
$8,761.50 |
| Rate for Payer: Adventist Health Commercial |
$2,336.40
|
| Rate for Payer: Cash Price |
$6,425.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,908.71
|
| Rate for Payer: Heritage Provider Network Senior |
$7,908.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,114.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,920.50
|
| Rate for Payer: Multiplan Commercial |
$8,761.50
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
OP
|
$11,682.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$2,336.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,025.53
|
| 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 |
$6,425.10
|
| Rate for Payer: Cash Price |
$6,425.10
|
| Rate for Payer: Cash Price |
$6,425.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,593.30
|
| 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 |
$7,908.71
|
| Rate for Payer: Heritage Provider Network Senior |
$7,908.71
|
| 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 |
$5,572.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,114.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,920.50
|
| 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 |
$8,761.50
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,203.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,867.91
|
| 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 PERC SKEL FIX OF FEM FRAC PROX
|
Facility
|
OP
|
$9,053.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
900501082
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$1,810.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,219.41
|
| 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 |
$8,785.00
|
| Rate for Payer: Cash Price |
$4,979.15
|
| Rate for Payer: Cash Price |
$4,979.15
|
| Rate for Payer: Cash Price |
$4,979.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,884.45
|
| 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 |
$6,128.88
|
| Rate for Payer: Heritage Provider Network Senior |
$6,128.88
|
| 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 |
$4,318.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,638.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,263.25
|
| 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 |
$6,789.75
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,257.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,997.45
|
| 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 PERC SKEL FIX OF FEM FRAC PROX
|
Facility
|
IP
|
$9,053.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
900501082
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,638.59 |
| Max. Negotiated Rate |
$6,789.75 |
| Rate for Payer: Adventist Health Commercial |
$1,810.60
|
| Rate for Payer: Cash Price |
$4,979.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,128.88
|
| Rate for Payer: Heritage Provider Network Senior |
$6,128.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,638.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,263.25
|
| Rate for Payer: Multiplan Commercial |
$6,789.75
|
|
|
HC PERC THROMB DIALYSIS CRCT
|
Facility
|
OP
|
$10,834.00
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
909036904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$2,166.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,442.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$5,958.70
|
| Rate for Payer: Cash Price |
$5,958.70
|
| Rate for Payer: Cash Price |
$5,958.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,042.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Senior |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,244.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,706.25
|
| Rate for Payer: Heritage Provider Network Senior |
$8,910.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,622.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,764.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,960.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,708.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,127.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,127.88
|
| Rate for Payer: Multiplan Commercial |
$8,125.50
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,968.78
|
| Rate for Payer: TriValley Medical Group Senior |
$7,968.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC PERC THROMB DIALYSIS CRCT
|
Facility
|
IP
|
$10,834.00
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
909036904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,960.95 |
| Max. Negotiated Rate |
$8,125.50 |
| Rate for Payer: Adventist Health Commercial |
$2,166.80
|
| Rate for Payer: Cash Price |
$5,958.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,334.62
|
| Rate for Payer: Heritage Provider Network Senior |
$7,334.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,960.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,708.50
|
| Rate for Payer: Multiplan Commercial |
$8,125.50
|
|
|
HC PERCT PLCMNT DUODENAL/JEJUNOST
|
Facility
|
OP
|
$6,157.00
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
909020003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,231.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,229.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$3,386.35
|
| Rate for Payer: Cash Price |
$3,386.35
|
| Rate for Payer: Cash Price |
$3,386.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,002.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Senior |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,410.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.18
|
| Rate for Payer: Heritage Provider Network Senior |
$2,964.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,771.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,579.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,771.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,539.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,037.00
|
| Rate for Payer: Multiplan Commercial |
$4,617.75
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,651.35
|
| Rate for Payer: TriValley Medical Group Senior |
$2,651.35
|
| 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 |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC PERCT PLCMNT DUODENAL/JEJUNOST
|
Facility
|
IP
|
$6,157.00
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
909020003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,114.42 |
| Max. Negotiated Rate |
$4,617.75 |
| Rate for Payer: Adventist Health Commercial |
$1,231.40
|
| Rate for Payer: Cash Price |
$3,386.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,168.29
|
| Rate for Payer: Heritage Provider Network Senior |
$4,168.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,539.25
|
| Rate for Payer: Multiplan Commercial |
$4,617.75
|
|
|
HC PERC TRANSPORTAL W HEMO
|
Facility
|
OP
|
$7,293.00
|
|
|
Service Code
|
CPT 75885
|
| Hospital Charge Code |
909081690
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$200.01 |
| Max. Negotiated Rate |
$5,998.81 |
| Rate for Payer: Adventist Health Commercial |
$1,458.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,898.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,010.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.22
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$4,011.15
|
| Rate for Payer: Cash Price |
$4,011.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,740.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,740.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,514.37
|
| Rate for Payer: Heritage Provider Network Senior |
$4,514.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$200.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,478.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,320.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$5,469.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,999.21
|
| Rate for Payer: TriValley Medical Group Senior |
$3,999.21
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PERC TRANSPORTAL W HEMO
|
Facility
|
IP
|
$7,293.00
|
|
|
Service Code
|
CPT 75885
|
| Hospital Charge Code |
909081690
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,320.03 |
| Max. Negotiated Rate |
$5,469.75 |
| Rate for Payer: Adventist Health Commercial |
$1,458.60
|
| Rate for Payer: Cash Price |
$4,011.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,937.36
|
| Rate for Payer: Heritage Provider Network Senior |
$4,937.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,320.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.25
|
| Rate for Payer: Multiplan Commercial |
$5,469.75
|
|
|
HC PERC TRANSPORTAL W/O HEMO
|
Facility
|
OP
|
$3,474.00
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
909081691
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$628.79 |
| Max. Negotiated Rate |
$5,998.81 |
| Rate for Payer: Adventist Health Commercial |
$694.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,856.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,386.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,291.22
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$1,910.70
|
| Rate for Payer: Cash Price |
$1,910.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,258.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,258.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,150.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,150.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,657.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$628.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$868.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$2,605.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,999.21
|
| Rate for Payer: TriValley Medical Group Senior |
$3,999.21
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,055.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,055.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PERC TRANSPORTAL W/O HEMO
|
Facility
|
IP
|
$3,474.00
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
909081691
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$628.79 |
| Max. Negotiated Rate |
$2,605.50 |
| Rate for Payer: Adventist Health Commercial |
$694.80
|
| Rate for Payer: Cash Price |
$1,910.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,351.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,351.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$628.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$868.50
|
| Rate for Payer: Multiplan Commercial |
$2,605.50
|
|
|
HC PERC TRLUML ANGP NAT/RECR COA
|
Facility
|
IP
|
$25,260.00
|
|
|
Service Code
|
CPT 33897
|
| Hospital Charge Code |
906820290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,572.06 |
| Max. Negotiated Rate |
$18,945.00 |
| Rate for Payer: Adventist Health Commercial |
$5,052.00
|
| Rate for Payer: Cash Price |
$13,893.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,101.02
|
| Rate for Payer: Heritage Provider Network Senior |
$17,101.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,572.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,315.00
|
| Rate for Payer: Multiplan Commercial |
$18,945.00
|
|
|
HC PERC TRLUML ANGP NAT/RECR COA
|
Facility
|
OP
|
$25,260.00
|
|
|
Service Code
|
CPT 33897
|
| Hospital Charge Code |
906820290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.40 |
| Max. Negotiated Rate |
$21,471.00 |
| Rate for Payer: Adventist Health Commercial |
$5,052.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,353.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,471.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,893.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,945.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$13,893.00
|
| Rate for Payer: Cash Price |
$13,893.00
|
| Rate for Payer: Cash Price |
$13,893.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,419.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,471.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,471.00
|
| Rate for Payer: Dignity Health Senior |
$21,471.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,635.94
|
| Rate for Payer: Heritage Provider Network Senior |
$15,635.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$154.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,049.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,572.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,315.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,682.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,682.00
|
| Rate for Payer: Multiplan Commercial |
$18,945.00
|
| 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 |
$21,471.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,471.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,471.00
|
|
