|
HC RMVL FECAL IMPACTION W/ANESTHE
|
Facility
OP
|
$3,735.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$676.04 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$747.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,565.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$1,680.75
|
| Rate for Payer: Cash Price |
$1,680.75
|
| Rate for Payer: Cash Price |
$1,680.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,427.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,528.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,528.60
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,800.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$676.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$933.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$2,801.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,356.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,247.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
OP
|
$754.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$85.38 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$518.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$363.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$468.23
|
| Rate for Payer: Blue Shield of California EPN |
$442.60
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$490.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$400.38
|
| Rate for Payer: Dignity Health Senior |
$363.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$363.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$466.73
|
| Rate for Payer: Heritage Provider Network Senior |
$447.70
|
| Rate for Payer: Humana Medicare |
$363.98
|
| Rate for Payer: IEHP Medi-Cal |
$85.38
|
| Rate for Payer: IEHP Medicare Advantage |
$363.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$691.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$429.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$458.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$458.61
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$400.38
|
| Rate for Payer: TriValley Medical Group Senior |
$400.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: Vantage Medical Group Senior |
$363.98
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
IP
|
$754.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$136.47 |
| Max. Negotiated Rate |
$565.50 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$518.00
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$510.46
|
| Rate for Payer: Heritage Provider Network Senior |
$510.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.50
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
IP
|
$487.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$88.15 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Adventist Health Commercial |
$97.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$334.57
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$329.70
|
| Rate for Payer: Heritage Provider Network Senior |
$329.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
OP
|
$487.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$88.15 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$97.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$334.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cash Price |
$219.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$316.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: Dignity Health Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$247.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$329.70
|
| Rate for Payer: Heritage Provider Network Senior |
$329.70
|
| Rate for Payer: Humana Medicare |
$247.49
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$247.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$234.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$311.84
|
| Rate for Payer: Multiplan Commercial |
$365.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$176.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$162.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC RMVL IMPACTED CERUMEN
|
Facility
IP
|
$499.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$90.32 |
| Max. Negotiated Rate |
$374.25 |
| Rate for Payer: Adventist Health Commercial |
$99.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$342.81
|
| Rate for Payer: Cash Price |
$224.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$337.82
|
| Rate for Payer: Heritage Provider Network Senior |
$337.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.75
|
| Rate for Payer: Multiplan Commercial |
$374.25
|
|
|
HC RMVL IMPACTED CERUMEN
|
Facility
OP
|
$499.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$99.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$342.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$224.55
|
| Rate for Payer: Cash Price |
$224.55
|
| Rate for Payer: Cash Price |
$224.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$324.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: Dignity Health Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$76.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$337.82
|
| Rate for Payer: Heritage Provider Network Senior |
$337.82
|
| Rate for Payer: Humana Medicare |
$76.42
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$240.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.29
|
| Rate for Payer: Multiplan Commercial |
$374.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$181.19
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$166.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
OP
|
$6,732.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,346.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,624.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$3,029.40
|
| Rate for Payer: Cash Price |
$3,029.40
|
| Rate for Payer: Cash Price |
$3,029.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,375.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,296.80
|
| Rate for Payer: Dignity Health Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,906.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,557.56
|
| Rate for Payer: Heritage Provider Network Senior |
$4,557.56
|
| Rate for Payer: Humana Medicare |
$3,906.18
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,244.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,609.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,683.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,921.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,921.79
|
| Rate for Payer: Multiplan Commercial |
$5,049.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,444.39
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,249.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
IP
|
$6,732.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,218.49 |
| Max. Negotiated Rate |
$5,049.00 |
| Rate for Payer: Adventist Health Commercial |
$1,346.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,624.88
|
| Rate for Payer: Cash Price |
$3,029.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,557.56
|
| Rate for Payer: Heritage Provider Network Senior |
$4,557.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,683.00
|
| Rate for Payer: Multiplan Commercial |
$5,049.00
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
OP
|
$7,997.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906820266
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$41.82 |
| Max. Negotiated Rate |
$18,042.00 |
| Rate for Payer: Adventist Health Commercial |
$1,599.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,493.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,797.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,398.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,997.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$3,598.65
|
| Rate for Payer: Cash Price |
$3,598.65
|
| Rate for Payer: Cash Price |
$3,598.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,198.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,797.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,797.45
|
| Rate for Payer: Dignity Health Senior |
$6,797.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,950.14
|
| Rate for Payer: Heritage Provider Network Senior |
$4,950.14
|
| Rate for Payer: IEHP Medi-Cal |
$41.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,854.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,447.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,999.25
|
| Rate for Payer: Multiplan Commercial |
$5,997.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,042.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,173.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,797.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,797.45
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
IP
|
$7,997.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906820266
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$5,997.75 |
| Rate for Payer: Adventist Health Commercial |
$1,599.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,493.94
|
| Rate for Payer: Cash Price |
$3,598.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,413.97
|
| Rate for Payer: Heritage Provider Network Senior |
$5,413.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,447.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,999.25
|
| Rate for Payer: Multiplan Commercial |
$5,997.75
|
|
|
HC RMVL INTRANASAL FB
|
Facility
OP
|
$804.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$258.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$522.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$387.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$603.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$291.93
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$268.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC RMVL INTRANASAL FB
|
Facility
IP
|
$804.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$603.00 |
| Rate for Payer: Adventist Health Commercial |
$160.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$552.35
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$544.31
|
| Rate for Payer: Heritage Provider Network Senior |
$544.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.00
|
| Rate for Payer: Multiplan Commercial |
$603.00
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
IP
|
$3,556.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$643.64 |
| Max. Negotiated Rate |
$2,667.00 |
| Rate for Payer: Adventist Health Commercial |
$711.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,442.97
|
| Rate for Payer: Cash Price |
$1,600.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,407.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,407.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.00
|
| Rate for Payer: Multiplan Commercial |
$2,667.00
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
OP
|
$3,556.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$643.64 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$711.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,442.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,600.20
|
| Rate for Payer: Cash Price |
$1,600.20
|
| Rate for Payer: Cash Price |
$1,600.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,311.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.96
|
| Rate for Payer: Dignity Health Senior |
$4,022.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,022.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,407.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,407.41
|
| Rate for Payer: Humana Medicare |
$4,022.69
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,022.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,713.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,746.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$889.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,068.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,068.59
|
| Rate for Payer: Multiplan Commercial |
$2,667.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,291.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,188.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Vantage Medical Group Senior |
$4,022.69
|
|
|
HC RMVL NASAL F.B.
|
Facility
IP
|
$3,605.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$652.50 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Adventist Health Commercial |
$721.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,476.64
|
| Rate for Payer: Cash Price |
$1,622.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,440.58
|
| Rate for Payer: Heritage Provider Network Senior |
$2,440.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$652.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$901.25
|
| Rate for Payer: Multiplan Commercial |
$2,703.75
|
|
|
HC RMVL NASAL F.B.
|
Facility
OP
|
$3,605.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$652.50 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$721.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,476.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$1,622.25
|
| Rate for Payer: Cash Price |
$1,622.25
|
| Rate for Payer: Cash Price |
$1,622.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,343.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.96
|
| Rate for Payer: Dignity Health Senior |
$4,022.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,022.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,440.58
|
| Rate for Payer: Heritage Provider Network Senior |
$2,440.58
|
| Rate for Payer: Humana Medicare |
$4,022.69
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,022.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,737.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$652.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,746.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$901.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,068.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,068.59
|
| Rate for Payer: Multiplan Commercial |
$2,703.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,308.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,204.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Vantage Medical Group Senior |
$4,022.69
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
OP
|
$1,968.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.21 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,352.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,264.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,279.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,391.47
|
| Rate for Payer: Dignity Health Senior |
$1,264.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,279.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,264.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,332.34
|
| Rate for Payer: Heritage Provider Network Senior |
$1,332.34
|
| Rate for Payer: Humana Medicare |
$1,264.97
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,264.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$948.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,492.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,593.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,593.86
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$714.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$657.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1,264.97
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
IP
|
$1,968.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.21 |
| Max. Negotiated Rate |
$1,476.00 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,352.02
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,332.34
|
| Rate for Payer: Heritage Provider Network Senior |
$1,332.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
OP
|
$3,347.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$605.81 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,299.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,175.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,265.92
|
| Rate for Payer: Heritage Provider Network Senior |
$2,265.92
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,613.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$836.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,215.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,118.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
IP
|
$3,347.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$605.81 |
| Max. Negotiated Rate |
$2,510.25 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,299.39
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,265.92
|
| Rate for Payer: Heritage Provider Network Senior |
$2,265.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$836.75
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
IP
|
$3,347.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$605.81 |
| Max. Negotiated Rate |
$2,510.25 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,299.39
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,265.92
|
| Rate for Payer: Heritage Provider Network Senior |
$2,265.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$836.75
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
OP
|
$3,347.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$605.81 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$669.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,299.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cash Price |
$1,506.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,175.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: Dignity Health Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,265.92
|
| Rate for Payer: Heritage Provider Network Senior |
$2,265.92
|
| Rate for Payer: Humana Medicare |
$2,025.69
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,613.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,390.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$836.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,552.37
|
| Rate for Payer: Multiplan Commercial |
$2,510.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,215.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,118.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
IP
|
$291.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$52.67 |
| Max. Negotiated Rate |
$218.25 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$199.92
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$197.01
|
| Rate for Payer: Heritage Provider Network Senior |
$197.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.75
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
OP
|
$291.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$52.67 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$199.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$189.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: Dignity Health Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$250.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$197.01
|
| Rate for Payer: Heritage Provider Network Senior |
$197.01
|
| Rate for Payer: Humana Medicare |
$250.14
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$140.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.18
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$105.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$97.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
