|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
OP
|
$8,209.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
906820206
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,641.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,639.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| 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 |
$4,514.95
|
| Rate for Payer: Cash Price |
$4,514.95
|
| Rate for Payer: Cash Price |
$4,514.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,335.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Senior |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,868.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,081.37
|
| Rate for Payer: Heritage Provider Network Senior |
$8,448.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$512.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,050.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,898.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,052.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,654.28
|
| Rate for Payer: Multiplan Commercial |
$6,156.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,555.33
|
| Rate for Payer: TriValley Medical Group Senior |
$7,555.33
|
| 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 |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
IP
|
$8,209.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
906820206
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,485.83 |
| Max. Negotiated Rate |
$6,156.75 |
| Rate for Payer: Adventist Health Commercial |
$1,641.80
|
| Rate for Payer: Cash Price |
$4,514.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,557.49
|
| Rate for Payer: Heritage Provider Network Senior |
$5,557.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,052.25
|
| Rate for Payer: Multiplan Commercial |
$6,156.75
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
IP
|
$8,169.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
909036253
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,478.59 |
| Max. Negotiated Rate |
$6,126.75 |
| Rate for Payer: Adventist Health Commercial |
$1,633.80
|
| Rate for Payer: Cash Price |
$4,492.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,530.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,530.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,042.25
|
| Rate for Payer: Multiplan Commercial |
$6,126.75
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
IP
|
$8,621.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
906820205
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,560.40 |
| Max. Negotiated Rate |
$6,465.75 |
| Rate for Payer: Adventist Health Commercial |
$1,724.20
|
| Rate for Payer: Cash Price |
$4,741.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,836.42
|
| Rate for Payer: Heritage Provider Network Senior |
$5,836.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,560.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,155.25
|
| Rate for Payer: Multiplan Commercial |
$6,465.75
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
OP
|
$8,169.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
909036251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,633.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,612.10
|
| 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 |
$6,004.00
|
| 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 |
$4,492.95
|
| Rate for Payer: Cash Price |
$4,492.95
|
| Rate for Payer: Cash Price |
$4,492.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,309.85
|
| 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 |
$5,056.61
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$369.12
|
| 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 |
$1,478.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,042.25
|
| 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 |
$6,126.75
|
| 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 RENAL SELECTIVE INC AO
|
Facility
|
IP
|
$8,169.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
909036251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,478.59 |
| Max. Negotiated Rate |
$6,126.75 |
| Rate for Payer: Adventist Health Commercial |
$1,633.80
|
| Rate for Payer: Cash Price |
$4,492.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,530.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,530.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,042.25
|
| Rate for Payer: Multiplan Commercial |
$6,126.75
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
OP
|
$8,621.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
906820205
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,724.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,922.63
|
| 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 |
$6,004.00
|
| 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 |
$4,741.55
|
| Rate for Payer: Cash Price |
$4,741.55
|
| Rate for Payer: Cash Price |
$4,741.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,603.65
|
| 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 |
$5,336.40
|
| Rate for Payer: Heritage Provider Network Senior |
$4,919.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$369.12
|
| 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 |
$1,560.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,155.25
|
| 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 |
$6,465.75
|
| 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 RENOGRAM WITH FLOW
|
Facility
|
IP
|
$2,686.00
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
909301426
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$486.17 |
| Max. Negotiated Rate |
$2,014.50 |
| Rate for Payer: Adventist Health Commercial |
$537.20
|
| Rate for Payer: Cash Price |
$1,477.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,818.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,818.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$671.50
|
| Rate for Payer: Multiplan Commercial |
$2,014.50
|
|
|
HC RENOGRAM WITH FLOW
|
Facility
|
OP
|
$2,686.00
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
909301426
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$312.58 |
| Max. Negotiated Rate |
$2,014.50 |
| Rate for Payer: Adventist Health Commercial |
$537.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,435.67
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,845.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Blue Shield of California Commercial |
$938.16
|
| Rate for Payer: Blue Shield of California EPN |
$754.44
|
| Rate for Payer: Cash Price |
$1,477.30
|
| Rate for Payer: Cash Price |
$1,477.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,745.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Senior |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,745.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$683.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,662.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,662.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$312.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,281.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$786.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$671.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$861.75
|
| Rate for Payer: Multiplan Commercial |
$2,014.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$752.32
|
| Rate for Payer: TriValley Medical Group Senior |
$683.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,343.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,343.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC REPAIR ARM TENDON/MUSCLE
|
Facility
|
OP
|
$10,964.00
|
|
|
Service Code
|
CPT 24341
|
| Hospital Charge Code |
900501446
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$2,192.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,532.27
|
| 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 |
$4,959.00
|
| Rate for Payer: Cash Price |
$6,030.20
|
| Rate for Payer: Cash Price |
$6,030.20
|
| Rate for Payer: Cash Price |
$6,030.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,126.60
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,076.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,422.63
|
| Rate for Payer: Heritage Provider Network Senior |
$7,422.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,229.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,984.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,741.00
|
| 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 |
$8,223.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,944.85
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,630.18
|
| 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
|
|
|
HC REPAIR ARM TENDON/MUSCLE
|
Facility
|
IP
|
$10,964.00
|
|
|
Service Code
|
CPT 24341
|
| Hospital Charge Code |
900501446
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,984.48 |
| Max. Negotiated Rate |
$8,223.00 |
| Rate for Payer: Adventist Health Commercial |
$2,192.80
|
| Rate for Payer: Cash Price |
$6,030.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,422.63
|
| Rate for Payer: Heritage Provider Network Senior |
$7,422.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,984.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,741.00
|
| Rate for Payer: Multiplan Commercial |
$8,223.00
|
|
|
HC REPAIR CMPLX TRUNK 1.1-2.5CM
|
Facility
|
OP
|
$3,326.00
|
|
|
Service Code
|
CPT 13100
|
| Hospital Charge Code |
900513100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$665.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,284.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$777.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$1,829.30
|
| Rate for Payer: Cash Price |
$1,829.30
|
| Rate for Payer: Cash Price |
$1,829.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,161.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.55
|
| Rate for Payer: Dignity Health Senior |
$777.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$777.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,251.70
|
| Rate for Payer: Heritage Provider Network Senior |
$2,251.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$777.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,586.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$894.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$979.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$979.99
|
| Rate for Payer: Multiplan Commercial |
$2,494.50
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,196.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,101.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Vantage Medical Group Senior |
$777.77
|
|
|
HC REPAIR CMPLX TRUNK 1.1-2.5CM
|
Facility
|
IP
|
$3,326.00
|
|
|
Service Code
|
CPT 13100
|
| Hospital Charge Code |
900513100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$602.01 |
| Max. Negotiated Rate |
$2,494.50 |
| Rate for Payer: Adventist Health Commercial |
$665.20
|
| Rate for Payer: Cash Price |
$1,829.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,251.70
|
| Rate for Payer: Heritage Provider Network Senior |
$2,251.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.50
|
| Rate for Payer: Multiplan Commercial |
$2,494.50
|
|
|
HC REPAIR FACIAL NERVE - EXTCRANI
|
Facility
|
IP
|
$11,928.00
|
|
|
Service Code
|
CPT 64864
|
| Hospital Charge Code |
900501591
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,158.97 |
| Max. Negotiated Rate |
$8,946.00 |
| Rate for Payer: Adventist Health Commercial |
$2,385.60
|
| Rate for Payer: Cash Price |
$6,560.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,075.26
|
| Rate for Payer: Heritage Provider Network Senior |
$8,075.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,158.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,982.00
|
| Rate for Payer: Multiplan Commercial |
$8,946.00
|
|
|
HC REPAIR FACIAL NERVE - EXTCRANI
|
Facility
|
OP
|
$11,928.00
|
|
|
Service Code
|
CPT 64864
|
| Hospital Charge Code |
900501591
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$12,964.88 |
| Rate for Payer: Adventist Health Commercial |
$2,385.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,194.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,205.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,950.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,137.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$6,560.40
|
| Rate for Payer: Cash Price |
$6,560.40
|
| Rate for Payer: Cash Price |
$6,560.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,753.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,205.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,950.71
|
| Rate for Payer: Dignity Health Senior |
$8,137.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,753.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,137.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,075.26
|
| Rate for Payer: Heritage Provider Network Senior |
$8,075.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,137.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,689.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,158.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,357.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,982.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,252.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,252.63
|
| Rate for Payer: Multiplan Commercial |
$8,946.00
|
| Rate for Payer: Multiplan WC |
$12,964.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4,291.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,949.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,205.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,950.71
|
| Rate for Payer: Vantage Medical Group Senior |
$8,137.01
|
|
|
HC REPAIR FINGER TENDON W/O GRAFT
|
Facility
|
OP
|
$3,990.00
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
900501399
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,741.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,903.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,435.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,321.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC REPAIR FINGER TENDON W/O GRAFT
|
Facility
|
IP
|
$3,990.00
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
900501399
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.19 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
|
|
HC REPAIR FLEXOR TENDON EA
|
Facility
|
OP
|
$6,591.00
|
|
|
Service Code
|
CPT 26350
|
| Hospital Charge Code |
900501285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,318.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,528.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$3,625.05
|
| Rate for Payer: Cash Price |
$3,625.05
|
| Rate for Payer: Cash Price |
$3,625.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,284.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,462.11
|
| Rate for Payer: Heritage Provider Network Senior |
$4,462.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,143.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,647.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$4,943.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,371.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,182.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC REPAIR FLEXOR TENDON EA
|
Facility
|
IP
|
$6,591.00
|
|
|
Service Code
|
CPT 26350
|
| Hospital Charge Code |
900501285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,192.97 |
| Max. Negotiated Rate |
$4,943.25 |
| Rate for Payer: Adventist Health Commercial |
$1,318.20
|
| Rate for Payer: Cash Price |
$3,625.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,462.11
|
| Rate for Payer: Heritage Provider Network Senior |
$4,462.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,647.75
|
| Rate for Payer: Multiplan Commercial |
$4,943.25
|
|
|
HC REPAIR FLEXOR TENDON,ZONE 2,EA
|
Facility
|
IP
|
$10,980.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
900501551
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,987.38 |
| Max. Negotiated Rate |
$8,235.00 |
| Rate for Payer: Adventist Health Commercial |
$2,196.00
|
| Rate for Payer: Cash Price |
$6,039.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,433.46
|
| Rate for Payer: Heritage Provider Network Senior |
$7,433.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,987.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Multiplan Commercial |
$8,235.00
|
|
|
HC REPAIR FLEXOR TENDON,ZONE 2,EA
|
Facility
|
OP
|
$10,980.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
900501551
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,196.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,543.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$6,039.00
|
| Rate for Payer: Cash Price |
$6,039.00
|
| Rate for Payer: Cash Price |
$6,039.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,137.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,433.46
|
| Rate for Payer: Heritage Provider Network Senior |
$7,433.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,237.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,987.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$8,235.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,950.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,635.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC REPAIR FOOT TENDON
|
Facility
|
OP
|
$5,054.00
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
900501722
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,010.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,472.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$2,779.70
|
| Rate for Payer: Cash Price |
$2,779.70
|
| Rate for Payer: Cash Price |
$2,779.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,285.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,421.56
|
| Rate for Payer: Heritage Provider Network Senior |
$3,421.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,410.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$914.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,263.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$3,790.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,818.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,673.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC REPAIR FOOT TENDON
|
Facility
|
IP
|
$5,054.00
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
900501722
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$914.77 |
| Max. Negotiated Rate |
$3,790.50 |
| Rate for Payer: Adventist Health Commercial |
$1,010.80
|
| Rate for Payer: Cash Price |
$2,779.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,421.56
|
| Rate for Payer: Heritage Provider Network Senior |
$3,421.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$914.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,263.50
|
| Rate for Payer: Multiplan Commercial |
$3,790.50
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
IP
|
$3,990.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.19 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
OP
|
$3,990.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$798.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,741.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cash Price |
$2,194.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,701.23
|
| Rate for Payer: Heritage Provider Network Senior |
$2,701.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,903.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$997.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$2,992.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,435.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,321.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
