|
HC PEROXIDASE STAIN
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
900910037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$792.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$680.06
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
|
|
HC PERQ ABLTJ LIVER CRYOABLATION
|
Facility
|
IP
|
$24,886.00
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
909047383
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,504.37 |
| Max. Negotiated Rate |
$18,664.50 |
| Rate for Payer: Adventist Health Commercial |
$4,977.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,026.58
|
| Rate for Payer: Cash Price |
$11,198.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,847.82
|
| Rate for Payer: Heritage Provider Network Senior |
$16,847.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,504.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,221.50
|
| Rate for Payer: Multiplan Commercial |
$18,664.50
|
|
|
HC PERQ ABLTJ LIVER CRYOABLATION
|
Facility
|
OP
|
$24,886.00
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
909047383
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,504.37 |
| Max. Negotiated Rate |
$25,976.31 |
| Rate for Payer: Adventist Health Commercial |
$4,977.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,379.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| 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 |
$11,198.70
|
| Rate for Payer: Cash Price |
$11,198.70
|
| Rate for Payer: Cash Price |
$11,198.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,175.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,671.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,404.43
|
| Rate for Payer: Heritage Provider Network Senior |
$16,816.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25,976.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,504.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,722.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,221.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$18,664.50
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,038.91
|
| Rate for Payer: TriValley Medical Group Senior |
$15,038.91
|
| 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 |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC PERQ CERVICOTHORACIC INJECT
|
Facility
|
OP
|
$13,725.00
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
909022510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,484.22 |
| Max. Negotiated Rate |
$10,293.75 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,482.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,921.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,208.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,495.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5,176.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,995.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,484.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,839.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,629.17
|
| Rate for Payer: TriValley Medical Group Senior |
$4,629.17
|
| 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 |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC PERQ CERVICOTHORACIC INJECT
|
Facility
|
IP
|
$13,725.00
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
909022510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,484.22 |
| Max. Negotiated Rate |
$10,293.75 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,838.90
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,319.00
|
| Rate for Payer: Heritage Provider Network Senior |
$3,928.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,484.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.25
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
|
|
HC PERQ IMPL OF NEUROSTIM ELECT
|
Facility
|
IP
|
$29,782.00
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
900100567
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,390.54 |
| Max. Negotiated Rate |
$22,336.50 |
| Rate for Payer: Adventist Health Commercial |
$5,956.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,179.61
|
| Rate for Payer: Cash Price |
$13,401.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,162.41
|
| Rate for Payer: Heritage Provider Network Senior |
$20,162.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,390.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,445.50
|
| Rate for Payer: Multiplan Commercial |
$22,336.50
|
|
|
HC PERQ IMPL OF NEUROSTIM ELECT
|
Facility
|
OP
|
$29,782.00
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
900100567
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,158.00 |
| Max. Negotiated Rate |
$22,336.50 |
| Rate for Payer: Adventist Health Commercial |
$5,956.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,405.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,295.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,016.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,196.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$13,401.90
|
| Rate for Payer: Cash Price |
$13,401.90
|
| Rate for Payer: Cash Price |
$13,401.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,358.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,295.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,016.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,196.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,869.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,196.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,435.06
|
| Rate for Payer: Heritage Provider Network Senior |
$10,081.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,196.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$15,573.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,390.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,426.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,445.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,983.63
|
| Rate for Payer: Multiplan Commercial |
$22,336.50
|
| Rate for Payer: Multiplan WC |
$13,286.43
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,016.41
|
| Rate for Payer: TriValley Medical Group Senior |
$9,016.41
|
| 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 |
$12,295.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,016.41
|
| Rate for Payer: Vantage Medical Group Senior |
$8,196.74
|
|
|
HC PERQ LUMBOSACRAL INJECT
|
Facility
|
IP
|
$13,725.00
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
909022511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,484.22 |
| Max. Negotiated Rate |
$10,293.75 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,838.90
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,319.00
|
| Rate for Payer: Heritage Provider Network Senior |
$3,928.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,484.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.25
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
|
|
HC PERQ LUMBOSACRAL INJECT
|
Facility
|
OP
|
$13,725.00
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
909022511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,484.22 |
| Max. Negotiated Rate |
$10,293.75 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,482.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,921.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,208.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,495.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5,176.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,995.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,484.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,839.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,629.17
|
| Rate for Payer: TriValley Medical Group Senior |
$4,629.17
|
| 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 |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC PERQ PRCRD DRG INS CATH CT GDN
|
Facility
|
OP
|
$1,328.00
|
|
|
Service Code
|
CPT 33019
|
| Hospital Charge Code |
900503019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$240.37 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$265.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$820.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,128.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$730.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$996.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| 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 |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$863.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,128.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,128.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,128.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$822.03
|
| Rate for Payer: Heritage Provider Network Senior |
$822.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$633.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.60
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| 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 |
$1,128.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,128.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,128.80
|
|
|
HC PERQ PRCRD DRG INS CATH CT GDN
|
Facility
|
IP
|
$1,328.00
|
|
|
Service Code
|
CPT 33019
|
| Hospital Charge Code |
900503019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$240.37 |
| Max. Negotiated Rate |
$996.00 |
| Rate for Payer: Adventist Health Commercial |
$265.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$855.23
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$899.06
|
| Rate for Payer: Heritage Provider Network Senior |
$899.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.00
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
|
|
HC PERQ STEN/CHEST VERT ART
|
Facility
|
IP
|
$28,772.00
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
909081390
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,207.73 |
| Max. Negotiated Rate |
$21,579.00 |
| Rate for Payer: Adventist Health Commercial |
$5,754.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,529.17
|
| Rate for Payer: Cash Price |
$12,947.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,478.64
|
| Rate for Payer: Heritage Provider Network Senior |
$19,478.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,207.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,193.00
|
| Rate for Payer: Multiplan Commercial |
$21,579.00
|
|
|
HC PERQ STEN/CHEST VERT ART
|
Facility
|
OP
|
$28,772.00
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
909081390
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$24,456.20 |
| Rate for Payer: Adventist Health Commercial |
$5,754.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,781.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24,456.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,579.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,108.00
|
| 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 |
$12,947.40
|
| Rate for Payer: Cash Price |
$12,947.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,701.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24,456.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,456.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,456.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,263.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,809.87
|
| Rate for Payer: Heritage Provider Network Senior |
$17,809.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,724.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,207.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,193.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20,140.40
|
| Rate for Payer: Multiplan Commercial |
$21,579.00
|
| 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 |
$24,456.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,456.20
|
| Rate for Payer: Vantage Medical Group Senior |
$24,456.20
|
|
|
HC PERQ TRANSCATH CLOSURE PDA
|
Facility
|
OP
|
$41,241.00
|
|
|
Service Code
|
CPT 93582
|
| Hospital Charge Code |
906811455
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,178.49 |
| Max. Negotiated Rate |
$44,797.35 |
| Rate for Payer: Adventist Health Commercial |
$8,248.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25,486.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| 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 |
$18,558.45
|
| Rate for Payer: Cash Price |
$18,558.45
|
| Rate for Payer: Cash Price |
$18,558.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,332.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$23,577.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,528.18
|
| Rate for Payer: Heritage Provider Network Senior |
$29,000.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$44,797.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,464.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,114.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,310.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$30,930.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,935.31
|
| Rate for Payer: TriValley Medical Group Senior |
$23,577.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC PERQ TRANSCATH CLOSURE PDA
|
Facility
|
IP
|
$41,241.00
|
|
|
Service Code
|
CPT 93582
|
| Hospital Charge Code |
906811455
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$30,930.75 |
| Rate for Payer: Adventist Health Commercial |
$8,248.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,559.20
|
| Rate for Payer: Cash Price |
$18,558.45
|
| Rate for Payer: Cash Price |
$18,558.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,464.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,310.25
|
| Rate for Payer: Multiplan Commercial |
$30,930.75
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
IP
|
$42,433.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
900093591
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$31,824.75 |
| Rate for Payer: Adventist Health Commercial |
$8,486.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27,326.85
|
| Rate for Payer: Cash Price |
$19,094.85
|
| Rate for Payer: Cash Price |
$19,094.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,680.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,608.25
|
| Rate for Payer: Multiplan Commercial |
$31,824.75
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
OP
|
$42,433.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
900093591
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,178.49 |
| Max. Negotiated Rate |
$44,797.35 |
| Rate for Payer: Adventist Health Commercial |
$8,486.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,223.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| 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 |
$19,094.85
|
| Rate for Payer: Cash Price |
$19,094.85
|
| Rate for Payer: Cash Price |
$19,094.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,035.47
|
| Rate for Payer: EPIC Health Plan Medicare |
$23,577.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$26,266.03
|
| Rate for Payer: Heritage Provider Network Senior |
$29,000.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$44,797.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,680.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,114.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,608.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$31,824.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,935.31
|
| Rate for Payer: TriValley Medical Group Senior |
$23,577.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
OP
|
$31,457.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906811590
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,693.72 |
| Max. Negotiated Rate |
$44,797.35 |
| Rate for Payer: Adventist Health Commercial |
$6,291.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,440.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$14,155.65
|
| Rate for Payer: Cash Price |
$14,155.65
|
| Rate for Payer: Cash Price |
$14,155.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,559.63
|
| Rate for Payer: EPIC Health Plan Medicare |
$23,577.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,471.88
|
| Rate for Payer: Heritage Provider Network Senior |
$29,000.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$44,797.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,693.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,114.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,864.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$23,592.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,935.31
|
| Rate for Payer: TriValley Medical Group Senior |
$23,577.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,953.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,939.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
IP
|
$31,457.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906811590
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$23,592.75 |
| Rate for Payer: Adventist Health Commercial |
$6,291.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,258.31
|
| Rate for Payer: Cash Price |
$14,155.65
|
| Rate for Payer: Cash Price |
$14,155.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,693.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,864.25
|
| Rate for Payer: Multiplan Commercial |
$23,592.75
|
|
|
HC PERQ TRNSCTH CLSRE EA OCC DVC
|
Facility
|
IP
|
$17,783.00
|
|
|
Service Code
|
CPT 93592
|
| Hospital Charge Code |
906811592
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,218.72 |
| Max. Negotiated Rate |
$13,337.25 |
| Rate for Payer: Adventist Health Commercial |
$3,556.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,452.25
|
| Rate for Payer: Cash Price |
$8,002.35
|
| Rate for Payer: Cash Price |
$8,002.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,218.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,445.75
|
| Rate for Payer: Multiplan Commercial |
$13,337.25
|
|
|
HC PERQ TRNSCTH CLSRE EA OCC DVC
|
Facility
|
OP
|
$17,783.00
|
|
|
Service Code
|
CPT 93592
|
| Hospital Charge Code |
906811592
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$15,115.55 |
| Rate for Payer: Adventist Health Commercial |
$3,556.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,989.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,115.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,780.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,337.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,728.00
|
| 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 |
$8,002.35
|
| Rate for Payer: Cash Price |
$8,002.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,115.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,115.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,115.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,491.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,007.68
|
| Rate for Payer: Heritage Provider Network Senior |
$11,007.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8,482.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,218.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,445.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,448.10
|
| Rate for Payer: Multiplan Commercial |
$13,337.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,115.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,115.55
|
| Rate for Payer: Vantage Medical Group Senior |
$15,115.55
|
|
|
HC PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$33,347.00
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
909022513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,928.00 |
| Max. Negotiated Rate |
$25,010.25 |
| Rate for Payer: Adventist Health Commercial |
$6,669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,475.47
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,319.00
|
| Rate for Payer: Heritage Provider Network Senior |
$3,928.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,035.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,336.75
|
| Rate for Payer: Multiplan Commercial |
$25,010.25
|
|
|
HC PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$33,347.00
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
909022515
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$28,344.95 |
| Rate for Payer: Adventist Health Commercial |
$6,669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,608.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28,344.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18,340.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25,010.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| 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 |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,675.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28,344.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$28,344.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,344.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,641.79
|
| Rate for Payer: Heritage Provider Network Senior |
$20,641.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$15,906.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,035.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,336.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$23,342.90
|
| Rate for Payer: Multiplan Commercial |
$25,010.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28,344.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28,344.95
|
| Rate for Payer: Vantage Medical Group Senior |
$28,344.95
|
|
|
HC PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$33,347.00
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
909022514
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,158.00 |
| Max. Negotiated Rate |
$25,010.25 |
| Rate for Payer: Adventist Health Commercial |
$6,669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,608.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,675.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,332.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,641.79
|
| Rate for Payer: Heritage Provider Network Senior |
$11,479.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$17,732.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,035.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,732.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,336.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$25,010.25
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$10,265.97
|
| Rate for Payer: TriValley Medical Group Senior |
$10,265.97
|
| 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 |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
HC PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$33,347.00
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
909022513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,158.00 |
| Max. Negotiated Rate |
$25,010.25 |
| Rate for Payer: Adventist Health Commercial |
$6,669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20,608.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cash Price |
$15,006.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,675.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,332.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,641.79
|
| Rate for Payer: Heritage Provider Network Senior |
$11,479.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$17,732.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,035.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,732.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,336.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$25,010.25
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$10,265.97
|
| Rate for Payer: TriValley Medical Group Senior |
$10,265.97
|
| 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 |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
