|
HC REMOVAL FOREIGN BODY PENILE
|
Facility
|
OP
|
$10,207.00
|
|
|
Service Code
|
CPT 54115
|
| Hospital Charge Code |
950442341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,847.47 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,041.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,307.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,848.32
|
| Rate for Payer: Blue Shield of California EPN |
$3,858.25
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,634.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,735.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,910.14
|
| Rate for Payer: Heritage Provider Network Senior |
$6,910.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,868.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,847.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,296.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$7,655.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,124.20
|
| Rate for Payer: TriValley Medical Group Senior |
$6,124.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC REMOVAL FOREIGN BODY PENILE
|
Facility
|
IP
|
$10,207.00
|
|
|
Service Code
|
CPT 54115
|
| Hospital Charge Code |
950442341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,847.47 |
| Max. Negotiated Rate |
$7,655.25 |
| Rate for Payer: Adventist Health Commercial |
$2,041.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,573.31
|
| Rate for Payer: Cash Price |
$4,593.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,910.14
|
| Rate for Payer: Heritage Provider Network Senior |
$6,910.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,847.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.75
|
| Rate for Payer: Multiplan Commercial |
$7,655.25
|
|
|
HC REMOVAL OF BREAST IMPLANT
|
Facility
|
OP
|
$13,020.00
|
|
|
Service Code
|
CPT 19328
|
| Hospital Charge Code |
900501758
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,356.62 |
| Max. Negotiated Rate |
$9,765.00 |
| Rate for Payer: Adventist Health Commercial |
$2,604.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,046.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,184.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,921.56
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,463.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$5,035.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,814.54
|
| Rate for Payer: Heritage Provider Network Senior |
$8,814.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$6,210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,356.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,791.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,255.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan Commercial |
$9,765.00
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,812.00
|
| Rate for Payer: TriValley Medical Group Senior |
$7,812.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
HC REMOVAL OF BREAST IMPLANT
|
Facility
|
IP
|
$13,020.00
|
|
|
Service Code
|
CPT 19328
|
| Hospital Charge Code |
900501758
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,356.62 |
| Max. Negotiated Rate |
$9,765.00 |
| Rate for Payer: Adventist Health Commercial |
$2,604.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,384.88
|
| Rate for Payer: Cash Price |
$5,859.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,814.54
|
| Rate for Payer: Heritage Provider Network Senior |
$8,814.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,255.00
|
| Rate for Payer: Multiplan Commercial |
$9,765.00
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$15,556.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906811997
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,815.64 |
| Max. Negotiated Rate |
$13,222.60 |
| Rate for Payer: Adventist Health Commercial |
$3,111.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,613.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,222.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,555.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,667.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| 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 |
$7,000.20
|
| Rate for Payer: Cash Price |
$7,000.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,111.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,222.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,222.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,222.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,629.16
|
| Rate for Payer: Heritage Provider Network Senior |
$9,629.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,420.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,815.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,889.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,889.20
|
| Rate for Payer: Multiplan Commercial |
$11,667.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,222.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,222.60
|
| Rate for Payer: Vantage Medical Group Senior |
$13,222.60
|
|
|
HC REMOVAL PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$15,556.00
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
906811997
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,815.64 |
| Max. Negotiated Rate |
$11,667.00 |
| Rate for Payer: Adventist Health Commercial |
$3,111.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,018.06
|
| Rate for Payer: Cash Price |
$7,000.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,531.41
|
| Rate for Payer: Heritage Provider Network Senior |
$10,531.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,815.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,889.00
|
| Rate for Payer: Multiplan Commercial |
$11,667.00
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
IP
|
$10,024.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,814.34 |
| Max. Negotiated Rate |
$7,518.00 |
| Rate for Payer: Adventist Health Commercial |
$2,004.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,455.46
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,786.25
|
| Rate for Payer: Heritage Provider Network Senior |
$6,786.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,814.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,506.00
|
| Rate for Payer: Multiplan Commercial |
$7,518.00
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
OP
|
$10,024.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,814.34 |
| Max. Negotiated Rate |
$7,518.00 |
| Rate for Payer: Adventist Health Commercial |
$2,004.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,194.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,968.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,761.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,789.07
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cash Price |
$4,510.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,515.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,265.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,968.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,515.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,968.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,786.25
|
| Rate for Payer: Heritage Provider Network Senior |
$6,786.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,781.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,814.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,506.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,977.45
|
| Rate for Payer: Multiplan Commercial |
$7,518.00
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,014.40
|
| Rate for Payer: TriValley Medical Group Senior |
$6,014.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Vantage Medical Group Senior |
$2,968.25
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
IP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,206.91 |
| Max. Negotiated Rate |
$5,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,294.19
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,514.24
|
| Rate for Payer: Heritage Provider Network Senior |
$4,514.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,206.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,667.00
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
OP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,206.91 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,120.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,334.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,127.49
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,206.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,667.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
IP
|
$10,951.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$8,213.25 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,052.44
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,413.83
|
| Rate for Payer: Heritage Provider Network Senior |
$7,413.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,982.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
OP
|
$10,951.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$13,102.72 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,767.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,896.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,118.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,585.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,896.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,896.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,778.67
|
| Rate for Payer: Heritage Provider Network Senior |
$8,482.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,102.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,982.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,930.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,240.87
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,585.79
|
| Rate for Payer: TriValley Medical Group Senior |
$7,585.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Vantage Medical Group Senior |
$6,896.17
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
OP
|
$10,951.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$13,102.72 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,767.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,896.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,118.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,585.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,896.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,896.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,778.67
|
| Rate for Payer: Heritage Provider Network Senior |
$8,482.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,102.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,982.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,930.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,240.87
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,585.79
|
| Rate for Payer: TriValley Medical Group Senior |
$7,585.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Vantage Medical Group Senior |
$6,896.17
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
IP
|
$10,951.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,982.13 |
| Max. Negotiated Rate |
$8,213.25 |
| Rate for Payer: Adventist Health Commercial |
$2,190.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,052.44
|
| Rate for Payer: Cash Price |
$4,927.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,413.83
|
| Rate for Payer: Heritage Provider Network Senior |
$7,413.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,982.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,737.75
|
| Rate for Payer: Multiplan Commercial |
$8,213.25
|
|
|
HC REMOVE LAMINA/FACETS LUMBAR
|
Facility
|
OP
|
$28,660.00
|
|
|
Service Code
|
CPT 63012
|
| Hospital Charge Code |
900100965
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,187.46 |
| Max. Negotiated Rate |
$21,495.00 |
| Rate for Payer: Adventist Health Commercial |
$5,732.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,711.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,829.24
|
| Rate for Payer: Blue Shield of California EPN |
$8,674.01
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,629.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,196.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9,332.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,740.54
|
| Rate for Payer: Heritage Provider Network Senior |
$11,479.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$17,732.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,187.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,732.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,165.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$21,495.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$10,265.97
|
| Rate for Payer: TriValley Medical Group Senior |
$10,265.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
HC REMOVE LAMINA/FACETS LUMBAR
|
Facility
|
IP
|
$28,660.00
|
|
|
Service Code
|
CPT 63012
|
| Hospital Charge Code |
900100965
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,187.46 |
| Max. Negotiated Rate |
$21,495.00 |
| Rate for Payer: Adventist Health Commercial |
$5,732.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,457.04
|
| Rate for Payer: Cash Price |
$12,897.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,402.82
|
| Rate for Payer: Heritage Provider Network Senior |
$19,402.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,187.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,165.00
|
| Rate for Payer: Multiplan Commercial |
$21,495.00
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
OP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$687.98 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,349.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,470.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,166.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,352.82
|
| Rate for Payer: Heritage Provider Network Senior |
$1,434.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,216.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$687.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,341.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,283.18
|
| Rate for Payer: TriValley Medical Group Senior |
$1,283.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
IP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$687.98 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,447.84
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,573.28
|
| Rate for Payer: Heritage Provider Network Senior |
$2,573.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$687.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.25
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
IP
|
$2,383.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$431.32 |
| Max. Negotiated Rate |
$1,787.25 |
| Rate for Payer: Adventist Health Commercial |
$476.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,534.65
|
| Rate for Payer: Cash Price |
$1,072.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,613.29
|
| Rate for Payer: Heritage Provider Network Senior |
$1,613.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$431.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$595.75
|
| Rate for Payer: Multiplan Commercial |
$1,787.25
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
OP
|
$2,383.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$309.26 |
| Max. Negotiated Rate |
$2,025.55 |
| Rate for Payer: Adventist Health Commercial |
$476.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,472.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,787.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$496.74
|
| Rate for Payer: Blue Shield of California Commercial |
$384.58
|
| Rate for Payer: Blue Shield of California EPN |
$309.26
|
| Rate for Payer: Cash Price |
$1,072.35
|
| Rate for Payer: Cash Price |
$1,072.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,548.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,025.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,025.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,475.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1,475.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,136.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$431.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$595.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,668.10
|
| Rate for Payer: Multiplan Commercial |
$1,787.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,191.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,191.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,025.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,025.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.55
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
IP
|
$9,605.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,738.51 |
| Max. Negotiated Rate |
$7,203.75 |
| Rate for Payer: Adventist Health Commercial |
$1,921.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,185.62
|
| Rate for Payer: Cash Price |
$4,322.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,502.59
|
| Rate for Payer: Heritage Provider Network Senior |
$6,502.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,738.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.25
|
| Rate for Payer: Multiplan Commercial |
$7,203.75
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$9,605.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,738.51 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,921.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,935.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$4,322.25
|
| Rate for Payer: Cash Price |
$4,322.25
|
| Rate for Payer: Cash Price |
$4,322.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,243.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,945.49
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,738.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$7,203.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$524.90 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,867.60
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,963.30
|
| Rate for Payer: Heritage Provider Network Senior |
$1,963.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$524.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.00
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$524.90 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,792.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$986.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$896.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,885.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$986.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$896.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$896.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,795.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,103.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$896.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,704.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$524.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,031.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,201.77
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Multiplan WC |
$1,351.26
|
| Rate for Payer: TriValley Medical Group Commercial |
$986.52
|
| Rate for Payer: TriValley Medical Group Senior |
$986.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$986.52
|
| Rate for Payer: Vantage Medical Group Senior |
$896.84
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$3,571.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.35 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Adventist Health Commercial |
$714.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,299.72
|
| Rate for Payer: Cash Price |
$1,606.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,417.57
|
| Rate for Payer: Heritage Provider Network Senior |
$2,417.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$646.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.75
|
| Rate for Payer: Multiplan Commercial |
$2,678.25
|
|
