|
HC REPAIR INTL INGUINAL HERNIA
|
Facility
|
OP
|
$7,750.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
900501740
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,550.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,324.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,037.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,246.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,246.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,696.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,402.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,937.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$5,812.50
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,788.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,566.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC REPAIR INTL INGUINAL HERNIA
|
Facility
|
IP
|
$7,750.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
900501740
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,402.75 |
| Max. Negotiated Rate |
$5,812.50 |
| Rate for Payer: Adventist Health Commercial |
$1,550.00
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,246.75
|
| Rate for Payer: Heritage Provider Network Senior |
$5,246.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,402.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,937.50
|
| Rate for Payer: Multiplan Commercial |
$5,812.50
|
|
|
HC REPAIR LACERATION CORNEA/SCLER
|
Facility
|
IP
|
$9,810.00
|
|
|
Service Code
|
CPT 65285
|
| Hospital Charge Code |
900501628
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,775.61 |
| Max. Negotiated Rate |
$7,357.50 |
| Rate for Payer: Adventist Health Commercial |
$1,962.00
|
| Rate for Payer: Cash Price |
$5,395.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,641.37
|
| Rate for Payer: Heritage Provider Network Senior |
$6,641.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,775.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,452.50
|
| Rate for Payer: Multiplan Commercial |
$7,357.50
|
|
|
HC REPAIR LACERATION CORNEA/SCLER
|
Facility
|
OP
|
$9,810.00
|
|
|
Service Code
|
CPT 65285
|
| Hospital Charge Code |
900501628
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,445.70 |
| Rate for Payer: Adventist Health Commercial |
$1,962.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,739.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,211.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,555.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$5,395.50
|
| Rate for Payer: Cash Price |
$5,395.50
|
| Rate for Payer: Cash Price |
$5,395.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,376.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,211.52
|
| Rate for Payer: Dignity Health Senior |
$6,555.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,376.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,555.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,641.37
|
| Rate for Payer: Heritage Provider Network Senior |
$6,641.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,555.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,679.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,775.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,539.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,452.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,260.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,260.47
|
| Rate for Payer: Multiplan Commercial |
$7,357.50
|
| Rate for Payer: Multiplan WC |
$10,445.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,529.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,248.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,211.52
|
| Rate for Payer: Vantage Medical Group Senior |
$6,555.93
|
|
|
HC REPAIR LIP, FULL THICKNESS
|
Facility
|
OP
|
$3,183.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
900501495
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,186.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,068.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Senior |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$647.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,154.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,154.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,518.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$744.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.28
|
| Rate for Payer: Multiplan Commercial |
$2,387.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,145.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,053.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
HC REPAIR LIP, FULL THICKNESS
|
Facility
|
IP
|
$3,183.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
900501495
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$576.12 |
| Max. Negotiated Rate |
$2,387.25 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,154.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,154.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.75
|
| Rate for Payer: Multiplan Commercial |
$2,387.25
|
|
|
HC REPAIR MOUTH LACERATION GT 2.5 C
|
Facility
|
OP
|
$3,183.00
|
|
|
Service Code
|
CPT 40831
|
| Hospital Charge Code |
900501471
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,186.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,068.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Senior |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$647.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,154.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,154.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,518.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$744.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.28
|
| Rate for Payer: Multiplan Commercial |
$2,387.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,145.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,053.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
HC REPAIR MOUTH LACERATION GT 2.5 C
|
Facility
|
IP
|
$3,183.00
|
|
|
Service Code
|
CPT 40831
|
| Hospital Charge Code |
900501471
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$576.12 |
| Max. Negotiated Rate |
$2,387.25 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Cash Price |
$1,750.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,154.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,154.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.75
|
| Rate for Payer: Multiplan Commercial |
$2,387.25
|
|
|
HC REPAIR MUSCLES OF HAND, EA
|
Facility
|
IP
|
$8,932.00
|
|
|
Service Code
|
CPT 26591
|
| Hospital Charge Code |
900501445
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,616.69 |
| Max. Negotiated Rate |
$6,699.00 |
| Rate for Payer: Adventist Health Commercial |
$1,786.40
|
| Rate for Payer: Cash Price |
$4,912.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,046.96
|
| Rate for Payer: Heritage Provider Network Senior |
$6,046.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,616.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,233.00
|
| Rate for Payer: Multiplan Commercial |
$6,699.00
|
|
|
HC REPAIR MUSCLES OF HAND, EA
|
Facility
|
OP
|
$8,932.00
|
|
|
Service Code
|
CPT 26591
|
| Hospital Charge Code |
900501445
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,786.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,136.28
|
| 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 |
$4,912.60
|
| Rate for Payer: Cash Price |
$4,912.60
|
| Rate for Payer: Cash Price |
$4,912.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,805.80
|
| 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 |
$6,046.96
|
| Rate for Payer: Heritage Provider Network Senior |
$6,046.96
|
| 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 |
$4,260.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,616.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,233.00
|
| 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 |
$6,699.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,213.73
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,957.39
|
| 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 OF CORNEAL LACERATION
|
Facility
|
OP
|
$5,773.00
|
|
|
Service Code
|
CPT 65280
|
| Hospital Charge Code |
900501665
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,445.70 |
| Rate for Payer: Adventist Health Commercial |
$1,154.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,966.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,211.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,555.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$3,175.15
|
| Rate for Payer: Cash Price |
$3,175.15
|
| Rate for Payer: Cash Price |
$3,175.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,752.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,211.52
|
| Rate for Payer: Dignity Health Senior |
$6,555.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,752.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,555.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,908.32
|
| Rate for Payer: Heritage Provider Network Senior |
$3,908.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,555.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,753.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,044.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,539.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,443.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,260.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,260.47
|
| Rate for Payer: Multiplan Commercial |
$4,329.75
|
| Rate for Payer: Multiplan WC |
$10,445.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,077.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,911.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,833.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,211.52
|
| Rate for Payer: Vantage Medical Group Senior |
$6,555.93
|
|
|
HC REPAIR OF CORNEAL LACERATION
|
Facility
|
IP
|
$5,773.00
|
|
|
Service Code
|
CPT 65280
|
| Hospital Charge Code |
900501665
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,044.91 |
| Max. Negotiated Rate |
$4,329.75 |
| Rate for Payer: Adventist Health Commercial |
$1,154.60
|
| Rate for Payer: Cash Price |
$3,175.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,908.32
|
| Rate for Payer: Heritage Provider Network Senior |
$3,908.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,044.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,443.25
|
| Rate for Payer: Multiplan Commercial |
$4,329.75
|
|
|
HC REPAIR OF EYE/LID WOUND
|
Facility
|
IP
|
$4,880.00
|
|
|
Service Code
|
CPT 65270
|
| Hospital Charge Code |
900501396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$883.28 |
| Max. Negotiated Rate |
$3,660.00 |
| Rate for Payer: Adventist Health Commercial |
$976.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,303.76
|
| Rate for Payer: Heritage Provider Network Senior |
$3,303.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$883.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,220.00
|
| Rate for Payer: Multiplan Commercial |
$3,660.00
|
|
|
HC REPAIR OF EYE/LID WOUND
|
Facility
|
OP
|
$4,880.00
|
|
|
Service Code
|
CPT 65270
|
| Hospital Charge Code |
900501396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Adventist Health Commercial |
$976.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,352.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cash Price |
$2,684.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,172.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Senior |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,172.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,964.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,303.76
|
| Rate for Payer: Heritage Provider Network Senior |
$3,303.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,327.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$883.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,408.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,220.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,734.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,734.97
|
| Rate for Payer: Multiplan Commercial |
$3,660.00
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,755.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,615.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
HC REPAIR OF HEART WOUND
|
Facility
|
OP
|
$2,701.00
|
|
|
Service Code
|
CPT 33300
|
| Hospital Charge Code |
900503330
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$328.10 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$540.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,855.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,295.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,485.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$1,485.55
|
| Rate for Payer: Cash Price |
$1,485.55
|
| Rate for Payer: Cash Price |
$1,485.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,755.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,295.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,295.85
|
| Rate for Payer: Dignity Health Senior |
$2,295.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,671.92
|
| Rate for Payer: Heritage Provider Network Senior |
$1,671.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,288.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$675.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,890.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,890.70
|
| Rate for Payer: Multiplan Commercial |
$2,025.75
|
| 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 |
$2,295.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,295.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,295.85
|
|
|
HC REPAIR OF HEART WOUND
|
Facility
|
IP
|
$2,701.00
|
|
|
Service Code
|
CPT 33300
|
| Hospital Charge Code |
900503330
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$488.88 |
| Max. Negotiated Rate |
$2,025.75 |
| Rate for Payer: Adventist Health Commercial |
$540.20
|
| Rate for Payer: Cash Price |
$1,485.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,828.58
|
| Rate for Payer: Heritage Provider Network Senior |
$1,828.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$675.25
|
| Rate for Payer: Multiplan Commercial |
$2,025.75
|
|
|
HC REPAIR OF THIGH MUSCLE
|
Facility
|
OP
|
$8,473.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
900501364
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$14,462.30 |
| Rate for Payer: Adventist Health Commercial |
$1,694.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,820.95
|
| 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 |
$6,004.00
|
| Rate for Payer: Cash Price |
$4,660.15
|
| Rate for Payer: Cash Price |
$4,660.15
|
| Rate for Payer: Cash Price |
$4,660.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,507.45
|
| 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 |
$5,736.22
|
| Rate for Payer: Heritage Provider Network Senior |
$5,736.22
|
| 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 |
$4,041.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,533.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,438.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,118.25
|
| 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 |
$6,354.75
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,048.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,805.41
|
| 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 OF THIGH MUSCLE
|
Facility
|
IP
|
$8,473.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
900501364
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,533.61 |
| Max. Negotiated Rate |
$6,354.75 |
| Rate for Payer: Adventist Health Commercial |
$1,694.60
|
| Rate for Payer: Cash Price |
$4,660.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,736.22
|
| Rate for Payer: Heritage Provider Network Senior |
$5,736.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,533.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,118.25
|
| Rate for Payer: Multiplan Commercial |
$6,354.75
|
|
|
HC REPAIR PALATE LAC GT 2CM
|
Facility
|
OP
|
$9,540.00
|
|
|
Service Code
|
CPT 42182
|
| Hospital Charge Code |
900501332
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$11,976.10 |
| Rate for Payer: Adventist Health Commercial |
$1,908.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,553.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,516.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$5,247.00
|
| Rate for Payer: Cash Price |
$5,247.00
|
| Rate for Payer: Cash Price |
$5,247.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,201.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,268.08
|
| Rate for Payer: Dignity Health Senior |
$7,516.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,516.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,458.58
|
| Rate for Payer: Heritage Provider Network Senior |
$6,458.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,516.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,550.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,726.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,643.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,470.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,470.71
|
| Rate for Payer: Multiplan Commercial |
$7,155.00
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,432.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,158.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7,516.44
|
|
|
HC REPAIR PALATE LAC GT 2CM
|
Facility
|
IP
|
$9,540.00
|
|
|
Service Code
|
CPT 42182
|
| Hospital Charge Code |
900501332
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,726.74 |
| Max. Negotiated Rate |
$7,155.00 |
| Rate for Payer: Adventist Health Commercial |
$1,908.00
|
| Rate for Payer: Cash Price |
$5,247.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,458.58
|
| Rate for Payer: Heritage Provider Network Senior |
$6,458.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,726.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.00
|
| Rate for Payer: Multiplan Commercial |
$7,155.00
|
|
|
HC REPAIR PROFUNDUS TENDON
|
Facility
|
IP
|
$6,591.00
|
|
|
Service Code
|
CPT 26370
|
| Hospital Charge Code |
900501318
|
|
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 PROFUNDUS TENDON
|
Facility
|
OP
|
$6,591.00
|
|
|
Service Code
|
CPT 26370
|
| Hospital Charge Code |
900501318
|
|
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 |
$8,111.00
|
| 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 SPICA BODY CAST/JACKET
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
900501112
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.33 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$316.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$407.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$385.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.54
|
| Rate for Payer: Dignity Health Senior |
$200.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$200.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$401.46
|
| Rate for Payer: Heritage Provider Network Senior |
$401.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$200.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$282.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$252.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$252.62
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$213.36
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$196.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Vantage Medical Group Senior |
$200.49
|
|
|
HC REPAIR SPICA BODY CAST/JACKET
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
900501112
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.33 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Cash Price |
$326.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$401.46
|
| Rate for Payer: Heritage Provider Network Senior |
$401.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.25
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
|
|
HC REPAIR TENDON EXTENSOR FOOT EA
|
Facility
|
OP
|
$5,054.00
|
|
|
Service Code
|
CPT 28208
|
| Hospital Charge Code |
900501348
|
|
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
|
|
