|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
IP
|
$16,468.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
909081844
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.71 |
| Max. Negotiated Rate |
$12,351.00 |
| Rate for Payer: Adventist Health Commercial |
$3,293.60
|
| Rate for Payer: Cash Price |
$9,057.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,148.84
|
| Rate for Payer: Heritage Provider Network Senior |
$11,148.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,980.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.00
|
| Rate for Payer: Multiplan Commercial |
$12,351.00
|
|
|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
OP
|
$16,468.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
909081844
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$13,997.80 |
| Rate for Payer: Adventist Health Commercial |
$3,293.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,313.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,997.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,057.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,351.00
|
| 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 |
$9,057.40
|
| Rate for Payer: Cash Price |
$9,057.40
|
| Rate for Payer: Cash Price |
$9,057.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,704.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,997.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,997.80
|
| Rate for Payer: Dignity Health Senior |
$13,997.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,193.69
|
| Rate for Payer: Heritage Provider Network Senior |
$10,193.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,389.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,855.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,980.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,527.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,527.60
|
| Rate for Payer: Multiplan Commercial |
$12,351.00
|
| 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 |
$13,997.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,997.80
|
| Rate for Payer: Vantage Medical Group Senior |
$13,997.80
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
IP
|
$4,628.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$837.67 |
| Max. Negotiated Rate |
$3,471.00 |
| Rate for Payer: Adventist Health Commercial |
$925.60
|
| Rate for Payer: Cash Price |
$2,545.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,133.16
|
| Rate for Payer: Heritage Provider Network Senior |
$3,133.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$837.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,157.00
|
| Rate for Payer: Multiplan Commercial |
$3,471.00
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
OP
|
$4,628.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4,723.01 |
| Rate for Payer: Adventist Health Commercial |
$925.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,179.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,545.40
|
| Rate for Payer: Cash Price |
$2,545.40
|
| Rate for Payer: Cash Price |
$2,545.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,008.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Senior |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,008.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,964.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,133.16
|
| Rate for Payer: Heritage Provider Network Senior |
$3,133.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,207.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$837.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,408.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,157.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,734.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,734.97
|
| Rate for Payer: Multiplan Commercial |
$3,471.00
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,665.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,532.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
IP
|
$4,880.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$883.28 |
| Max. Negotiated Rate |
$3,660.00 |
| Rate for Payer: Adventist Health Commercial |
$976.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,303.76
|
| Rate for Payer: Heritage Provider Network Senior |
$3,303.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$883.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,220.00
|
| Rate for Payer: Multiplan Commercial |
$3,660.00
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
OP
|
$4,880.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Adventist Health Commercial |
$976.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,352.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,172.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Senior |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,172.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,964.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,303.76
|
| Rate for Payer: Heritage Provider Network Senior |
$3,303.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,327.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$883.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,408.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,220.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,734.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,734.97
|
| Rate for Payer: Multiplan Commercial |
$3,660.00
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,755.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,615.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
OP
|
$2,107.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$421.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,447.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,158.85
|
| Rate for Payer: Cash Price |
$1,158.85
|
| Rate for Payer: Cash Price |
$1,158.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,369.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$569.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$417.80
|
| Rate for Payer: Dignity Health Senior |
$379.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,369.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$379.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,426.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,426.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$379.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,005.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$381.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$436.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$478.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$478.57
|
| Rate for Payer: Multiplan Commercial |
$1,580.25
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$758.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$697.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Vantage Medical Group Senior |
$379.82
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
IP
|
$2,107.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$381.37 |
| Max. Negotiated Rate |
$1,580.25 |
| Rate for Payer: Adventist Health Commercial |
$421.40
|
| Rate for Payer: Cash Price |
$1,158.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,426.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,426.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$381.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.75
|
| Rate for Payer: Multiplan Commercial |
$1,580.25
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$655.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.56 |
| Max. Negotiated Rate |
$491.25 |
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$443.44
|
| Rate for Payer: Heritage Provider Network Senior |
$443.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.75
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$655.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.26 |
| Max. Negotiated Rate |
$491.25 |
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$350.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$449.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$309.96
|
| Rate for Payer: Blue Shield of California Commercial |
$273.20
|
| Rate for Payer: Blue Shield of California EPN |
$219.13
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Cash Price |
$360.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$425.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.19
|
| Rate for Payer: Dignity Health Senior |
$39.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$39.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$405.44
|
| Rate for Payer: Heritage Provider Network Senior |
$405.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$312.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.47
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$39.26
|
| Rate for Payer: TriValley Medical Group Senior |
$39.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$42.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$42.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$194.98
|
| Rate for Payer: Heritage Provider Network Senior |
$194.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.22 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$153.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$197.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.30
|
| Rate for Payer: Blue Shield of California Commercial |
$159.90
|
| Rate for Payer: Blue Shield of California EPN |
$128.25
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$187.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.94
|
| Rate for Payer: Dignity Health Senior |
$27.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$27.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.27
|
| Rate for Payer: Heritage Provider Network Senior |
$178.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$35.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$137.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.30
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$27.22
|
| Rate for Payer: TriValley Medical Group Senior |
$27.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Vantage Medical Group Senior |
$27.22
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,176.71 |
| Max. Negotiated Rate |
$9,019.50 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| Rate for Payer: Cash Price |
$6,614.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,141.60
|
| Rate for Payer: Heritage Provider Network Senior |
$8,141.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,176.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,006.50
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6,427.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,261.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$6,614.30
|
| Rate for Payer: Cash Price |
$6,614.30
|
| Rate for Payer: Cash Price |
$6,614.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,816.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Senior |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,191.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,141.60
|
| Rate for Payer: Heritage Provider Network Senior |
$8,141.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,736.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,176.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,369.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,006.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,500.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,500.99
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,326.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,981.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$300.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,030.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$915.00
|
| Rate for Payer: Blue Shield of California EPN |
$732.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$975.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Senior |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$295.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$928.50
|
| Rate for Payer: Heritage Provider Network Senior |
$928.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$715.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.78
|
| Rate for Payer: Multiplan Commercial |
$1,125.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$324.57
|
| Rate for Payer: TriValley Medical Group Senior |
$295.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$300.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,030.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$975.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Senior |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$295.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,015.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,015.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$715.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.78
|
| Rate for Payer: Multiplan Commercial |
$1,125.00
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$539.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$496.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$271.50 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Adventist Health Commercial |
$300.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,015.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,015.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.00
|
| Rate for Payer: Multiplan Commercial |
$1,125.00
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$271.50 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Adventist Health Commercial |
$300.00
|
| Rate for Payer: Cash Price |
$825.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,015.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,015.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.00
|
| Rate for Payer: Multiplan Commercial |
$1,125.00
|
|
|
HC PROCEDURE ANUS
|
Facility
|
OP
|
$2,288.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$457.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,571.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,487.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Senior |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,158.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,548.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,548.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,091.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$414.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,332.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,459.61
|
| Rate for Payer: Multiplan Commercial |
$1,716.00
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$823.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$757.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC PROCEDURE ANUS
|
Facility
|
IP
|
$2,288.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.13 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Adventist Health Commercial |
$457.60
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,548.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,548.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$414.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Multiplan Commercial |
$1,716.00
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
OP
|
$937.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$187.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$500.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$643.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$515.35
|
| Rate for Payer: Cash Price |
$515.35
|
| Rate for Payer: Cash Price |
$515.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$609.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Senior |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$785.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.35
|
| Rate for Payer: Heritage Provider Network Senior |
$634.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$446.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$989.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$989.81
|
| Rate for Payer: Multiplan Commercial |
$702.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$337.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$310.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
IP
|
$937.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$702.75 |
| Rate for Payer: Adventist Health Commercial |
$187.40
|
| Rate for Payer: Cash Price |
$515.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.35
|
| Rate for Payer: Heritage Provider Network Senior |
$634.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.25
|
| Rate for Payer: Multiplan Commercial |
$702.75
|
|
|
HC PROCEDURE NOSE
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$792.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$191.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
|
|
HC PROCEDURE NOSE
|
Facility
|
OP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$725.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$686.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Senior |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$295.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$503.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$191.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.78
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$379.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$349.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
OP
|
$1,314.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$262.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$902.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,915.00
|
| Rate for Payer: Cash Price |
$722.70
|
| Rate for Payer: Cash Price |
$722.70
|
| Rate for Payer: Cash Price |
$722.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$854.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Senior |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$295.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$889.58
|
| Rate for Payer: Heritage Provider Network Senior |
$889.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$626.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.78
|
| Rate for Payer: Multiplan Commercial |
$985.50
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$472.78
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$435.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
