|
HC REDUCTION OF INTUSSUSCEPTION
|
Facility
|
IP
|
$892.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
909001805
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$161.45 |
| Max. Negotiated Rate |
$669.00 |
| Rate for Payer: Adventist Health Commercial |
$178.40
|
| Rate for Payer: Cash Price |
$401.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$603.88
|
| Rate for Payer: Heritage Provider Network Senior |
$603.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$223.00
|
| Rate for Payer: Multiplan Commercial |
$669.00
|
|
|
HC REFILL/MAIN IMPL PUMP/RESV
|
Facility
|
OP
|
$638.00
|
|
|
Service Code
|
CPT 95990
|
| Hospital Charge Code |
911801003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$80.22 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$127.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$341.01
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$438.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$638.00
|
| Rate for Payer: Blue Shield of California EPN |
$512.00
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$414.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Senior |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$421.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$394.92
|
| Rate for Payer: Heritage Provider Network Senior |
$394.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$80.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$421.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$304.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$531.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$531.03
|
| Rate for Payer: Multiplan Commercial |
$478.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$463.60
|
| Rate for Payer: TriValley Medical Group Senior |
$421.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$764.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$641.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC REFILL/MAIN IMPL PUMP/RESV
|
Facility
|
IP
|
$638.00
|
|
|
Service Code
|
CPT 95990
|
| Hospital Charge Code |
911801003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$115.48 |
| Max. Negotiated Rate |
$478.50 |
| Rate for Payer: Adventist Health Commercial |
$127.60
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$431.93
|
| Rate for Payer: Heritage Provider Network Senior |
$431.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.50
|
| Rate for Payer: Multiplan Commercial |
$478.50
|
|
|
HC RELEASE OF EYE FLUID
|
Facility
|
IP
|
$10,302.00
|
|
|
Service Code
|
CPT 67015
|
| Hospital Charge Code |
900501531
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,864.66 |
| Max. Negotiated Rate |
$7,726.50 |
| Rate for Payer: Adventist Health Commercial |
$2,060.40
|
| Rate for Payer: Cash Price |
$4,635.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,974.45
|
| Rate for Payer: Heritage Provider Network Senior |
$6,974.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,864.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,575.50
|
| Rate for Payer: Multiplan Commercial |
$7,726.50
|
|
|
HC RELEASE OF EYE FLUID
|
Facility
|
OP
|
$10,302.00
|
|
|
Service Code
|
CPT 67015
|
| Hospital Charge Code |
900501531
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$7,726.50 |
| Rate for Payer: Adventist Health Commercial |
$2,060.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,077.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$4,635.90
|
| Rate for Payer: Cash Price |
$4,635.90
|
| Rate for Payer: Cash Price |
$4,635.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,696.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Senior |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,696.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,897.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,974.45
|
| Rate for Payer: Heritage Provider Network Senior |
$6,974.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,914.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,864.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,332.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,575.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,651.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,651.35
|
| Rate for Payer: Multiplan Commercial |
$7,726.50
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,706.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,410.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC REMOVAL FOREIGN BODY PENILE
|
Facility
|
OP
|
$10,207.00
|
|
|
Service Code
|
CPT 54115
|
| Hospital Charge Code |
950442341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,041.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,012.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,634.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Senior |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,636.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,910.14
|
| Rate for Payer: Heritage Provider Network Senior |
$6,910.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,868.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,847.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,182.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,582.02
|
| Rate for Payer: Multiplan Commercial |
$7,655.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,672.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,379.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC REMOVAL FOREIGN BODY PENILE
|
Facility
|
IP
|
$10,207.00
|
|
|
Service Code
|
CPT 54115
|
| Hospital Charge Code |
950442341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,847.47 |
| Max. Negotiated Rate |
$7,655.25 |
| Rate for Payer: Adventist Health Commercial |
$2,041.40
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,910.14
|
| Rate for Payer: Heritage Provider Network Senior |
$6,910.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,847.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.75
|
| Rate for Payer: Multiplan Commercial |
$7,655.25
|
|
|
HC REMOVAL LV LEAD PACE OR ICD
|
Facility
|
IP
|
$8,294.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820316
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,501.21 |
| Max. Negotiated Rate |
$6,220.50 |
| Rate for Payer: Adventist Health Commercial |
$1,658.80
|
| Rate for Payer: Cash Price |
$3,732.30
|
| Rate for Payer: Cash Price |
$3,732.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,501.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,073.50
|
| Rate for Payer: Multiplan Commercial |
$6,220.50
|
|
|
HC REMOVAL LV LEAD PACE OR ICD
|
Facility
|
OP
|
$8,294.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820316
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$1,658.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,433.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,697.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| 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 |
$3,732.30
|
| Rate for Payer: Cash Price |
$3,732.30
|
| Rate for Payer: Cash Price |
$3,732.30
|
| Rate for Payer: Cash Price |
$3,732.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,391.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Senior |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,391.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,133.99
|
| Rate for Payer: Heritage Provider Network Senior |
$244.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$377.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,501.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,073.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$250.49
|
| Rate for Payer: Multiplan Commercial |
$6,220.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$218.68
|
| Rate for Payer: TriValley Medical Group Senior |
$198.80
|
| 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 |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC REMOVAL OF BREAST IMPLANT
|
Facility
|
OP
|
$13,020.00
|
|
|
Service Code
|
CPT 19328
|
| Hospital Charge Code |
900501758
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,765.00 |
| Rate for Payer: Adventist Health Commercial |
$2,604.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,944.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,865.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,463.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,352.03
|
| Rate for Payer: Dignity Health Senior |
$4,865.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,865.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,814.54
|
| Rate for Payer: Heritage Provider Network Senior |
$8,814.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,865.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,210.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,356.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,595.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,255.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,130.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,130.50
|
| Rate for Payer: Multiplan Commercial |
$9,765.00
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,684.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4,310.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Vantage Medical Group Senior |
$4,865.48
|
|
|
HC REMOVAL OF BREAST IMPLANT
|
Facility
|
IP
|
$13,020.00
|
|
|
Service Code
|
CPT 19328
|
| Hospital Charge Code |
900501758
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,356.62 |
| Max. Negotiated Rate |
$9,765.00 |
| Rate for Payer: Adventist Health Commercial |
$2,604.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,814.54
|
| Rate for Payer: Heritage Provider Network Senior |
$8,814.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,255.00
|
| Rate for Payer: Multiplan Commercial |
$9,765.00
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$15,556.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906811997
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,815.64 |
| Max. Negotiated Rate |
$11,667.00 |
| Rate for Payer: Adventist Health Commercial |
$3,111.20
|
| Rate for Payer: Cash Price |
$7,000.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,531.41
|
| Rate for Payer: Heritage Provider Network Senior |
$10,531.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,815.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,889.00
|
| Rate for Payer: Multiplan Commercial |
$11,667.00
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$15,556.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906811997
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$43.43 |
| Max. Negotiated Rate |
$13,222.60 |
| Rate for Payer: Adventist Health Commercial |
$3,111.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,686.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,222.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,555.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,667.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$7,000.20
|
| Rate for Payer: Cash Price |
$7,000.20
|
| Rate for Payer: Cash Price |
$7,000.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,111.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,222.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,222.60
|
| Rate for Payer: Dignity Health Senior |
$13,222.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,629.16
|
| Rate for Payer: Heritage Provider Network Senior |
$9,629.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,420.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,815.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,889.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,889.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,889.20
|
| Rate for Payer: Multiplan Commercial |
$11,667.00
|
| 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 |
$13,222.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,222.60
|
| Rate for Payer: Vantage Medical Group Senior |
$13,222.60
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$20,413.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906820321
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,694.75 |
| Max. Negotiated Rate |
$15,309.75 |
| Rate for Payer: Adventist Health Commercial |
$4,082.60
|
| Rate for Payer: Cash Price |
$9,185.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,819.60
|
| Rate for Payer: Heritage Provider Network Senior |
$13,819.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,694.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,103.25
|
| Rate for Payer: Multiplan Commercial |
$15,309.75
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$20,413.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906820321
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$43.43 |
| Max. Negotiated Rate |
$17,351.05 |
| Rate for Payer: Adventist Health Commercial |
$4,082.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,023.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,351.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,227.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,309.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$9,185.85
|
| Rate for Payer: Cash Price |
$9,185.85
|
| Rate for Payer: Cash Price |
$9,185.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,268.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,351.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,351.05
|
| Rate for Payer: Dignity Health Senior |
$17,351.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,635.65
|
| Rate for Payer: Heritage Provider Network Senior |
$12,635.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9,737.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,694.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,103.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,289.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,289.10
|
| Rate for Payer: Multiplan Commercial |
$15,309.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,351.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,351.05
|
| Rate for Payer: Vantage Medical Group Senior |
$17,351.05
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
IP
|
$10,024.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,814.34 |
| Max. Negotiated Rate |
$7,518.00 |
| Rate for Payer: Adventist Health Commercial |
$2,004.80
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,786.25
|
| Rate for Payer: Heritage Provider Network Senior |
$6,786.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,814.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,506.00
|
| Rate for Payer: Multiplan Commercial |
$7,518.00
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
OP
|
$10,024.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$7,518.00 |
| Rate for Payer: Adventist Health Commercial |
$2,004.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,886.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,515.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Senior |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,515.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,897.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,786.25
|
| Rate for Payer: Heritage Provider Network Senior |
$6,786.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,781.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,814.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,332.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,506.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,651.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,651.35
|
| Rate for Payer: Multiplan Commercial |
$7,518.00
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,606.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,318.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
IP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,206.91 |
| Max. Negotiated Rate |
$5,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,514.24
|
| Rate for Payer: Heritage Provider Network Senior |
$4,514.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,206.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,667.00
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
OP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,580.92
|
| 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 |
$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 |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,334.20
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,127.49
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,179.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,598.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,206.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,667.00
|
| 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 |
$5,001.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,399.13
|
| Rate for Payer: TriValley Medical Group Senior |
$4,399.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| 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 REMOVE FOREIGN BODY (RENAL)
|
Facility
|
OP
|
$10,951.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$12,272.58 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,523.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,459.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,118.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,105.18
|
| Rate for Payer: Dignity Health Senior |
$6,459.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,459.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,778.67
|
| Rate for Payer: Heritage Provider Network Senior |
$7,944.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$683.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,459.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,272.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,428.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,138.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,138.65
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,105.18
|
| Rate for Payer: TriValley Medical Group Senior |
$7,105.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Vantage Medical Group Senior |
$6,459.25
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
IP
|
$10,951.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$8,213.25 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,413.83
|
| Rate for Payer: Heritage Provider Network Senior |
$7,413.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
OP
|
$10,951.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$12,272.58 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,523.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,459.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,118.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,105.18
|
| Rate for Payer: Dignity Health Senior |
$6,459.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,459.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,778.67
|
| Rate for Payer: Heritage Provider Network Senior |
$7,944.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$808.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,459.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,272.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,428.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,138.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,138.65
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,105.18
|
| Rate for Payer: TriValley Medical Group Senior |
$7,105.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Vantage Medical Group Senior |
$6,459.25
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
IP
|
$10,951.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$8,213.25 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,413.83
|
| Rate for Payer: Heritage Provider Network Senior |
$7,413.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
|
|
HC REMOVE LAMINA/FACETS LUMBAR
|
Facility
|
IP
|
$28,660.00
|
|
|
Service Code
|
CPT 63012
|
| Hospital Charge Code |
900100965
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,187.46 |
| Max. Negotiated Rate |
$21,495.00 |
| Rate for Payer: Adventist Health Commercial |
$5,732.00
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,402.82
|
| Rate for Payer: Heritage Provider Network Senior |
$19,402.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,187.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,165.00
|
| Rate for Payer: Multiplan Commercial |
$21,495.00
|
|
|
HC REMOVE LAMINA/FACETS LUMBAR
|
Facility
|
OP
|
$28,660.00
|
|
|
Service Code
|
CPT 63012
|
| Hospital Charge Code |
900100965
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$21,495.00 |
| Rate for Payer: Adventist Health Commercial |
$5,732.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,689.42
|
| 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 |
$10,680.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,629.00
|
| 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 |
$17,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,076.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,740.54
|
| Rate for Payer: Heritage Provider Network Senior |
$11,164.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$337.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,245.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,187.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,165.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,436.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,436.79
|
| Rate for Payer: Multiplan Commercial |
$21,495.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,984.50
|
| Rate for Payer: TriValley Medical Group Senior |
$9,984.50
|
| 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 |
$13,615.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,076.82
|
|
