|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
IP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,336.32 |
| Max. Negotiated Rate |
$5,537.25 |
| Rate for Payer: Adventist Health Commercial |
$1,476.60
|
| Rate for Payer: Cash Price |
$4,060.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,998.29
|
| Rate for Payer: Heritage Provider Network Senior |
$4,998.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,336.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,845.75
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
OP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,476.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,072.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,039.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$4,060.65
|
| Rate for Payer: Cash Price |
$4,060.65
|
| Rate for Payer: Cash Price |
$4,060.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,798.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,443.90
|
| Rate for Payer: Dignity Health Senior |
$4,039.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,039.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,998.29
|
| Rate for Payer: Heritage Provider Network Senior |
$4,998.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,039.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,521.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,336.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,645.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,845.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,090.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,090.29
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,656.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,444.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,039.91
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906820266
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,375.06 |
| Max. Negotiated Rate |
$5,697.75 |
| Rate for Payer: Adventist Health Commercial |
$1,519.40
|
| Rate for Payer: Cash Price |
$4,178.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,143.17
|
| Rate for Payer: Heritage Provider Network Senior |
$5,143.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,375.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,899.25
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906820266
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$18,953.00 |
| Rate for Payer: Adventist Health Commercial |
$1,519.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,219.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,178.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,697.75
|
| 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 |
$4,178.35
|
| Rate for Payer: Cash Price |
$4,178.35
|
| Rate for Payer: Cash Price |
$4,178.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,938.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,457.45
|
| Rate for Payer: Dignity Health Senior |
$6,457.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,702.54
|
| Rate for Payer: Heritage Provider Network Senior |
$4,702.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,623.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,375.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,899.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,317.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,317.90
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| 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 |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,457.45
|
|
|
HC RMVL INTRANASAL FB
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$659.25 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
|
|
HC RMVL INTRANASAL FB
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.10 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$469.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$603.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$571.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$595.08
|
| Rate for Payer: Heritage Provider Network Senior |
$595.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$419.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$659.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$316.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$291.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
|
IP
|
$3,885.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$703.18 |
| Max. Negotiated Rate |
$2,913.75 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
|
OP
|
$3,885.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,668.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,525.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,853.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,397.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,286.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC RMVL NASAL F.B.
|
Facility
|
OP
|
$3,939.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$787.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,706.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,166.45
|
| Rate for Payer: Cash Price |
$2,166.45
|
| Rate for Payer: Cash Price |
$2,166.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,560.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,666.70
|
| Rate for Payer: Heritage Provider Network Senior |
$2,666.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,878.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$712.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$2,954.25
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,417.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,304.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC RMVL NASAL F.B.
|
Facility
|
IP
|
$3,939.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$712.96 |
| Max. Negotiated Rate |
$2,954.25 |
| Rate for Payer: Adventist Health Commercial |
$787.80
|
| Rate for Payer: Cash Price |
$2,166.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,666.70
|
| Rate for Payer: Heritage Provider Network Senior |
$2,666.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$712.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.75
|
| Rate for Payer: Multiplan Commercial |
$2,954.25
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
OP
|
$1,994.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$398.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,369.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,230.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,096.70
|
| Rate for Payer: Cash Price |
$1,096.70
|
| Rate for Payer: Cash Price |
$1,096.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,296.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,353.69
|
| Rate for Payer: Dignity Health Senior |
$1,230.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,296.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,230.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,349.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,349.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,230.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$951.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,415.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,550.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,550.59
|
| Rate for Payer: Multiplan Commercial |
$1,495.50
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$717.44
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$660.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,230.63
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
IP
|
$1,994.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$360.91 |
| Max. Negotiated Rate |
$1,495.50 |
| Rate for Payer: Adventist Health Commercial |
$398.80
|
| Rate for Payer: Cash Price |
$1,096.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,349.94
|
| Rate for Payer: Heritage Provider Network Senior |
$1,349.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.50
|
| Rate for Payer: Multiplan Commercial |
$1,495.50
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
|
IP
|
$3,657.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$661.92 |
| Max. Negotiated Rate |
$2,742.75 |
| Rate for Payer: Adventist Health Commercial |
$731.40
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,475.79
|
| Rate for Payer: Heritage Provider Network Senior |
$2,475.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.25
|
| Rate for Payer: Multiplan Commercial |
$2,742.75
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
|
OP
|
$3,657.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$731.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,512.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,377.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,475.79
|
| Rate for Payer: Heritage Provider Network Senior |
$2,475.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,744.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$2,742.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,315.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,210.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
|
IP
|
$3,657.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$661.92 |
| Max. Negotiated Rate |
$2,742.75 |
| Rate for Payer: Adventist Health Commercial |
$731.40
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,475.79
|
| Rate for Payer: Heritage Provider Network Senior |
$2,475.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.25
|
| Rate for Payer: Multiplan Commercial |
$2,742.75
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
|
OP
|
$3,657.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$731.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,512.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cash Price |
$2,011.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,377.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Senior |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,058.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,475.79
|
| Rate for Payer: Heritage Provider Network Senior |
$2,475.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,744.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,367.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.94
|
| Rate for Payer: Multiplan Commercial |
$2,742.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,315.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,210.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$317.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$63.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$217.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$174.35
|
| Rate for Payer: Cash Price |
$174.35
|
| Rate for Payer: Cash Price |
$174.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$206.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Senior |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$252.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$214.61
|
| Rate for Payer: Heritage Provider Network Senior |
$214.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$151.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$318.11
|
| Rate for Payer: Multiplan Commercial |
$237.75
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$114.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$104.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$57.38 |
| Max. Negotiated Rate |
$237.75 |
| Rate for Payer: Adventist Health Commercial |
$63.40
|
| Rate for Payer: Cash Price |
$174.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$214.61
|
| Rate for Payer: Heritage Provider Network Senior |
$214.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.25
|
| Rate for Payer: Multiplan Commercial |
$237.75
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.79 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$246.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$316.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$281.21
|
| Rate for Payer: Blue Shield of California EPN |
$224.97
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$299.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Senior |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$337.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$285.36
|
| Rate for Payer: Heritage Provider Network Senior |
$285.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$219.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$388.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$425.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.19
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$371.19
|
| Rate for Payer: TriValley Medical Group Senior |
$371.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$230.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$230.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$345.75 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$312.10
|
| Rate for Payer: Heritage Provider Network Senior |
$312.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.25
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
OP
|
$10,504.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,100.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,216.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,827.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,501.98
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,626.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$7,878.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$4,624.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
IP
|
$10,504.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,901.22 |
| Max. Negotiated Rate |
$7,878.00 |
| Rate for Payer: Adventist Health Commercial |
$2,100.80
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,626.00
|
| Rate for Payer: Multiplan Commercial |
$7,878.00
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
IP
|
$10,504.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,901.22 |
| Max. Negotiated Rate |
$7,878.00 |
| Rate for Payer: Adventist Health Commercial |
$2,100.80
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,626.00
|
| Rate for Payer: Multiplan Commercial |
$7,878.00
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
OP
|
$10,504.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,100.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,216.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,827.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,501.98
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,626.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$7,878.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$4,624.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE DFB LEAD
|
Facility
|
OP
|
$10,504.00
|
|
|
Service Code
|
CPT 0921T
|
| Hospital Charge Code |
906811509
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,100.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,216.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cash Price |
$5,777.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,827.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,501.98
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,626.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$7,878.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$4,624.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
