|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
IP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$687.98 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,573.28
|
| Rate for Payer: Heritage Provider Network Senior |
$2,573.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$687.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.25
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
OP
|
$2,383.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.96 |
| Max. Negotiated Rate |
$2,025.55 |
| Rate for Payer: Adventist Health Commercial |
$476.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,273.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,637.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,787.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$477.63
|
| Rate for Payer: Blue Shield of California Commercial |
$384.58
|
| Rate for Payer: Blue Shield of California EPN |
$309.26
|
| Rate for Payer: Cash Price |
$1,310.65
|
| Rate for Payer: Cash Price |
$1,310.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,548.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,025.55
|
| Rate for Payer: Dignity Health Senior |
$2,025.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,548.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,475.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1,475.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$160.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,136.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$431.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$595.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,668.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,668.10
|
| Rate for Payer: Multiplan Commercial |
$1,787.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,191.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,191.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,025.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.55
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
IP
|
$2,383.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$431.32 |
| Max. Negotiated Rate |
$1,787.25 |
| Rate for Payer: Adventist Health Commercial |
$476.60
|
| Rate for Payer: Cash Price |
$1,310.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,613.29
|
| Rate for Payer: Heritage Provider Network Senior |
$1,613.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$431.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$595.75
|
| Rate for Payer: Multiplan Commercial |
$1,787.25
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$9,605.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,921.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,598.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$5,282.75
|
| Rate for Payer: Cash Price |
$5,282.75
|
| Rate for Payer: Cash Price |
$5,282.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,243.25
|
| 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 |
$5,945.49
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$509.64
|
| 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 |
$1,738.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$7,203.75
|
| 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 PERM CANNULA/CATHETER
|
Facility
|
IP
|
$9,605.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,738.51 |
| Max. Negotiated Rate |
$7,203.75 |
| Rate for Payer: Adventist Health Commercial |
$1,921.00
|
| Rate for Payer: Cash Price |
$5,282.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,502.59
|
| Rate for Payer: Heritage Provider Network Senior |
$6,502.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,738.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.25
|
| Rate for Payer: Multiplan Commercial |
$7,203.75
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$524.90 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,963.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,963.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$524.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.00
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,992.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$932.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$848.09
|
| 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 |
$1,595.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,885.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$932.90
|
| Rate for Payer: Dignity Health Senior |
$848.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$848.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,795.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,043.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$736.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$848.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,611.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$524.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$975.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,068.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,068.59
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Multiplan WC |
$1,351.26
|
| Rate for Payer: TriValley Medical Group Commercial |
$932.90
|
| Rate for Payer: TriValley Medical Group Senior |
$932.90
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$932.90
|
| Rate for Payer: Vantage Medical Group Senior |
$848.09
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,453.28
|
| 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 |
$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 |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,321.15
|
| 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 |
$2,210.45
|
| Rate for Payer: Heritage Provider Network Senior |
$966.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$220.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,492.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| 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 |
$2,678.25
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$864.12
|
| Rate for Payer: TriValley Medical Group Senior |
$864.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| 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 REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.35 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,417.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,417.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| Rate for Payer: Multiplan Commercial |
$2,678.25
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.35 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,417.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,417.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| Rate for Payer: Multiplan Commercial |
$2,678.25
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,453.28
|
| 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 |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,321.15
|
| 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 |
$2,417.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,417.57
|
| 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 |
$1,703.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| 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 |
$2,678.25
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,284.85
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,182.36
|
| 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 REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$646.35 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,417.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,417.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| Rate for Payer: Multiplan Commercial |
$2,678.25
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,453.28
|
| 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 |
$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 |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cash Price |
$1,964.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,321.15
|
| 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 |
$2,210.45
|
| Rate for Payer: Heritage Provider Network Senior |
$966.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$220.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,492.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$646.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| 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 |
$2,678.25
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$864.12
|
| Rate for Payer: TriValley Medical Group Senior |
$864.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| 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 REMOVE TUNNEL PLEURAL CATH
|
Facility
|
OP
|
$2,537.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$507.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,742.92
|
| 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 |
$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 |
$1,395.35
|
| Rate for Payer: Cash Price |
$1,395.35
|
| Rate for Payer: Cash Price |
$1,395.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,649.05
|
| 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 |
$1,570.40
|
| Rate for Payer: Heritage Provider Network Senior |
$966.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$247.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,492.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$634.25
|
| 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 |
$1,902.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$864.12
|
| Rate for Payer: TriValley Medical Group Senior |
$864.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| 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 REMOVE TUNNEL PLEURAL CATH
|
Facility
|
IP
|
$2,537.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$1,902.75 |
| Rate for Payer: Adventist Health Commercial |
$507.40
|
| Rate for Payer: Cash Price |
$1,395.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,717.55
|
| Rate for Payer: Heritage Provider Network Senior |
$1,717.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$634.25
|
| Rate for Payer: Multiplan Commercial |
$1,902.75
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
OP
|
$8,617.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,723.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,919.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| 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 |
$4,739.35
|
| Rate for Payer: Cash Price |
$4,739.35
|
| Rate for Payer: Cash Price |
$4,739.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,601.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Senior |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,602.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,333.92
|
| Rate for Payer: Heritage Provider Network Senior |
$3,201.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,134.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,945.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,559.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,993.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,279.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,279.58
|
| Rate for Payer: Multiplan Commercial |
$6,462.75
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,863.12
|
| Rate for Payer: TriValley Medical Group Senior |
$2,863.12
|
| 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 |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
IP
|
$8,617.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,559.68 |
| Max. Negotiated Rate |
$6,462.75 |
| Rate for Payer: Adventist Health Commercial |
$1,723.40
|
| Rate for Payer: Cash Price |
$4,739.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,833.71
|
| Rate for Payer: Heritage Provider Network Senior |
$5,833.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,559.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.25
|
| Rate for Payer: Multiplan Commercial |
$6,462.75
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,110.25 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cash Price |
$3,373.70
|
| 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 |
$1,110.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.50
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$7,217.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$269.00 |
| Max. Negotiated Rate |
$10,551.84 |
| Rate for Payer: Adventist Health Commercial |
$1,443.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,857.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,958.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,134.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,969.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,412.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,134.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,134.45
|
| Rate for Payer: Dignity Health Senior |
$6,134.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,467.32
|
| Rate for Payer: Heritage Provider Network Senior |
$4,467.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$269.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,442.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,306.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,804.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,051.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,051.90
|
| Rate for Payer: Multiplan Commercial |
$5,412.75
|
| 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 |
$6,134.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,134.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,134.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$7,217.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,306.28 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,443.40
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cash Price |
$3,969.35
|
| 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 |
$1,306.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,804.25
|
| Rate for Payer: Multiplan Commercial |
$5,412.75
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$269.00 |
| Max. Negotiated Rate |
$10,551.84 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,278.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,214.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,373.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,600.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,551.84
|
| Rate for Payer: Blue Shield of California EPN |
$8,451.82
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,213.90
|
| Rate for Payer: Dignity Health Senior |
$5,213.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,796.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3,796.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$269.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,925.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,110.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,293.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| 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 |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,213.90
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
OP
|
$3,885.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$6,565.51 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,668.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,525.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,525.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,853.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,397.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,286.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
IP
|
$3,885.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$703.18 |
| Max. Negotiated Rate |
$2,913.75 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$4,717.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$943.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,240.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,594.35
|
| Rate for Payer: Cash Price |
$2,594.35
|
| Rate for Payer: Cash Price |
$2,594.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,066.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Senior |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,973.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,193.41
|
| Rate for Payer: Heritage Provider Network Senior |
$3,193.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,250.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$853.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,269.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,179.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,486.99
|
| Rate for Payer: Multiplan Commercial |
$3,537.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,697.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,561.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$4,717.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$853.78 |
| Max. Negotiated Rate |
$3,537.75 |
| Rate for Payer: Adventist Health Commercial |
$943.40
|
| Rate for Payer: Cash Price |
$2,594.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,193.41
|
| Rate for Payer: Heritage Provider Network Senior |
$3,193.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$853.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,179.25
|
| Rate for Payer: Multiplan Commercial |
$3,537.75
|
|
