|
HC NUTR THER INIT EVAL 15 MIN
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
902000200
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$175.95 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$103.54
|
| Rate for Payer: Blue Shield of California Commercial |
$126.27
|
| Rate for Payer: Blue Shield of California EPN |
$101.02
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$134.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$175.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$128.13
|
| Rate for Payer: Heritage Provider Network Senior |
$128.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$98.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC NUTR THER INIT EVAL 15 MIN
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
902000200
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$37.47 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$133.31
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$140.14
|
| Rate for Payer: Heritage Provider Network Senior |
$140.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.75
|
| Rate for Payer: Multiplan Commercial |
$155.25
|
|
|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43.79
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.04
|
| Rate for Payer: Heritage Provider Network Senior |
$46.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
|
|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Adventist Health Commercial |
$27.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.01
|
| Rate for Payer: Blue Shield of California Commercial |
$41.48
|
| Rate for Payer: Blue Shield of California EPN |
$33.18
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$44.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$57.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$57.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$42.09
|
| Rate for Payer: Heritage Provider Network Senior |
$42.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$32.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$158.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57.80
|
| Rate for Payer: Vantage Medical Group Senior |
$57.80
|
|
|
HC NVLGN JGLR VENA CAVA FLTER SET
|
Facility
|
OP
|
$3,885.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909000880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$777.00 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,400.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,302.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,136.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,913.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,561.77
|
| Rate for Payer: Blue Shield of California EPN |
$1,561.77
|
| Rate for Payer: Cash Price |
$1,748.25
|
| Rate for Payer: Cash Price |
$1,748.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,787.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,302.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,302.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,302.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,486.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,798.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,798.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,942.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,942.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,942.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,719.50
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,403.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,286.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,302.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,302.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,302.25
|
|
|
HC NVLGN JGLR VENA CAVA FLTER SET
|
Facility
|
IP
|
$3,885.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909000880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$777.00 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,501.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,561.77
|
| Rate for Payer: Blue Shield of California EPN |
$1,561.77
|
| Rate for Payer: Cash Price |
$1,748.25
|
| Rate for Payer: Cash Price |
$1,748.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,787.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,097.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,798.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,798.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,942.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,942.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,942.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,403.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,286.32
|
|
|
HC O2/CO2 EXHALED AIR ANALYSIS RSPC
|
Facility
|
IP
|
$846.00
|
|
|
Service Code
|
CPT 94681
|
| Hospital Charge Code |
900894681
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$634.50 |
| Rate for Payer: Adventist Health Commercial |
$169.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$544.82
|
| Rate for Payer: Cash Price |
$380.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$572.74
|
| Rate for Payer: Heritage Provider Network Senior |
$572.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.50
|
| Rate for Payer: Multiplan Commercial |
$634.50
|
|
|
HC O2/CO2 EXHALED AIR ANALYSIS RSPC
|
Facility
|
OP
|
$846.00
|
|
|
Service Code
|
CPT 94681
|
| Hospital Charge Code |
900894681
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$719.91 |
| Rate for Payer: Adventist Health Commercial |
$169.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$522.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$423.17
|
| Rate for Payer: Blue Shield of California Commercial |
$532.42
|
| Rate for Payer: Blue Shield of California EPN |
$428.15
|
| Rate for Payer: Cash Price |
$380.70
|
| Rate for Payer: Cash Price |
$380.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$549.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$479.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$523.67
|
| Rate for Payer: Heritage Provider Network Senior |
$523.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$403.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$551.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$634.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$527.93
|
| Rate for Payer: TriValley Medical Group Senior |
$479.94
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$423.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$423.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC O2 UPTAKE REST EXERCISE
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 94680
|
| Hospital Charge Code |
900801032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$374.26 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$238.10
|
| Rate for Payer: Blue Shield of California Commercial |
$374.26
|
| Rate for Payer: Blue Shield of California EPN |
$300.96
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.84
|
| Rate for Payer: EPIC Health Plan Medicare |
$165.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.64
|
| Rate for Payer: Heritage Provider Network Senior |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$227.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$182.04
|
| Rate for Payer: TriValley Medical Group Senior |
$165.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$238.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$238.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC O2 UPTAKE REST EXERCISE
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 94680
|
| Hospital Charge Code |
900801032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$306.54
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC O2 UPTAKE REST INDIRECT
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
900801015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$210.59
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$221.38
|
| Rate for Payer: Heritage Provider Network Senior |
$221.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$59.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
|
|
HC O2 UPTAKE REST INDIRECT
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
900801015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$399.65 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$202.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.57
|
| Rate for Payer: Blue Shield of California Commercial |
$399.65
|
| Rate for Payer: Blue Shield of California EPN |
$321.38
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$212.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$75.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.41
|
| Rate for Payer: Heritage Provider Network Senior |
$202.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$155.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$59.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$83.46
|
| Rate for Payer: TriValley Medical Group Senior |
$75.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$163.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$163.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC OBSTETRIC PANEL
|
Facility
|
OP
|
$284.00
|
|
|
Service Code
|
CPT 80055
|
| Hospital Charge Code |
900913621
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$274.70 |
| Rate for Payer: Adventist Health Commercial |
$56.80
|
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$74.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$175.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.35
|
| Rate for Payer: Blue Shield of California Commercial |
$274.70
|
| Rate for Payer: Blue Shield of California Commercial |
$274.70
|
| Rate for Payer: Blue Shield of California EPN |
$220.91
|
| Rate for Payer: Blue Shield of California EPN |
$220.91
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$78.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$184.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$47.81
|
| Rate for Payer: EPIC Health Plan Medicare |
$47.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$175.80
|
| Rate for Payer: Heritage Provider Network Senior |
$74.28
|
| Rate for Payer: Heritage Provider Network Senior |
$175.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$57.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$135.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$51.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$64.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$64.07
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$213.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$47.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$47.81
|
| Rate for Payer: TriValley Medical Group Senior |
$47.81
|
| Rate for Payer: TriValley Medical Group Senior |
$47.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$51.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$51.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$51.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$51.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.59
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
|
|
HC OBSTETRIC PANEL
|
Facility
|
IP
|
$284.00
|
|
|
Service Code
|
CPT 80055
|
| Hospital Charge Code |
900913621
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Adventist Health Commercial |
$56.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$182.90
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$192.27
|
| Rate for Payer: Heritage Provider Network Senior |
$192.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$51.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.00
|
| Rate for Payer: Multiplan Commercial |
$213.00
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP ADDL FETUS
|
Facility
|
IP
|
$2,059.00
|
|
|
Service Code
|
CPT 76816 59
|
| Hospital Charge Code |
906601320
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$372.68 |
| Max. Negotiated Rate |
$1,544.25 |
| Rate for Payer: Adventist Health Commercial |
$411.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,326.00
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,393.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,393.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$514.75
|
| Rate for Payer: Multiplan Commercial |
$1,544.25
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP ADDL FETUS
|
Facility
|
OP
|
$2,059.00
|
|
|
Service Code
|
CPT 76816 59
|
| Hospital Charge Code |
906601320
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.67 |
| Max. Negotiated Rate |
$1,750.15 |
| Rate for Payer: Adventist Health Commercial |
$411.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,272.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,750.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,132.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,544.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,029.91
|
| Rate for Payer: Blue Shield of California Commercial |
$234.91
|
| Rate for Payer: Blue Shield of California EPN |
$188.91
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,338.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,750.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,750.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,750.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,214.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,274.52
|
| Rate for Payer: Heritage Provider Network Senior |
$1,274.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$982.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$514.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,441.30
|
| Rate for Payer: Multiplan Commercial |
$1,544.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,750.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,750.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,750.15
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP SINGLE FETUS
|
Facility
|
IP
|
$2,059.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601311
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$372.68 |
| Max. Negotiated Rate |
$1,544.25 |
| Rate for Payer: Adventist Health Commercial |
$411.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,326.00
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,393.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,393.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$514.75
|
| Rate for Payer: Multiplan Commercial |
$1,544.25
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP SINGLE FETUS
|
Facility
|
OP
|
$2,059.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601311
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.67 |
| Max. Negotiated Rate |
$1,544.25 |
| Rate for Payer: Adventist Health Commercial |
$411.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,272.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,029.91
|
| Rate for Payer: Blue Shield of California Commercial |
$234.91
|
| Rate for Payer: Blue Shield of California EPN |
$188.91
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Cash Price |
$926.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,338.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,214.81
|
| Rate for Payer: EPIC Health Plan Medicare |
$134.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,274.52
|
| Rate for Payer: Heritage Provider Network Senior |
$1,274.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$982.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$514.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,544.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$134.46
|
| Rate for Payer: TriValley Medical Group Senior |
$134.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC OB US AFI LMTD 1 OR MORE FETUS
|
Facility
|
OP
|
$1,032.00
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
910400110
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.67 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Adventist Health Commercial |
$206.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$637.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$516.21
|
| Rate for Payer: Blue Shield of California Commercial |
$300.43
|
| Rate for Payer: Blue Shield of California EPN |
$241.60
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$670.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$608.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$134.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$638.81
|
| Rate for Payer: Heritage Provider Network Senior |
$638.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$492.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$186.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$134.46
|
| Rate for Payer: TriValley Medical Group Senior |
$134.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$100.67
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$100.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC OB US AFI LMTD 1 OR MORE FETUS
|
Facility
|
IP
|
$1,032.00
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
910400110
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$186.79 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Adventist Health Commercial |
$206.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$664.61
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$698.66
|
| Rate for Payer: Heritage Provider Network Senior |
$698.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$186.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.00
|
| Rate for Payer: Multiplan Commercial |
$774.00
|
|
|
HC OCCLUSION CATHETER
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
909081214
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.69 |
| Max. Negotiated Rate |
$505.75 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$367.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$327.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$446.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$297.62
|
| Rate for Payer: Blue Shield of California Commercial |
$362.95
|
| Rate for Payer: Blue Shield of California EPN |
$290.36
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$386.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$505.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$505.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$505.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$368.31
|
| Rate for Payer: Heritage Provider Network Senior |
$368.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$283.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$416.50
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$297.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$297.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$505.75
|
| Rate for Payer: Vantage Medical Group Senior |
$505.75
|
|
|
HC OCCLUSION CATHETER
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
909081214
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.69 |
| Max. Negotiated Rate |
$446.25 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$383.18
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$402.81
|
| Rate for Payer: Heritage Provider Network Senior |
$402.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.75
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
|
|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
|
IP
|
$981.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.56 |
| Max. Negotiated Rate |
$735.75 |
| Rate for Payer: Adventist Health Commercial |
$196.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$631.76
|
| Rate for Payer: Cash Price |
$441.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$664.14
|
| Rate for Payer: Heritage Provider Network Senior |
$664.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$245.25
|
| Rate for Payer: Multiplan Commercial |
$735.75
|
|
|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
|
OP
|
$981.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.56 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$196.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$606.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$833.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$539.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$735.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 |
$441.45
|
| Rate for Payer: Cash Price |
$441.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$637.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$833.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$833.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$833.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$607.24
|
| Rate for Payer: Heritage Provider Network Senior |
$607.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$467.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$245.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$686.70
|
| Rate for Payer: Multiplan Commercial |
$735.75
|
| 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 |
$833.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$833.85
|
| Rate for Payer: Vantage Medical Group Senior |
$833.85
|
|
|
HC OCC THER APP OF SURFACE NEUROSTIMULATOR
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 64550
|
| Hospital Charge Code |
901307015
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.87 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$110.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.50
|
| 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 |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$175.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$229.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$167.13
|
| Rate for Payer: Heritage Provider Network Senior |
$167.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$128.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| 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 |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
