|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Adventist Health Commercial |
$358.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,229.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$894.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$813.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,163.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$894.48
|
| Rate for Payer: Dignity Health Senior |
$813.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,163.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$813.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,211.83
|
| Rate for Payer: Heritage Provider Network Senior |
$1,211.83
|
| Rate for Payer: Humana Medicare |
$813.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$813.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$862.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$323.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$959.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,024.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,024.58
|
| Rate for Payer: Multiplan Commercial |
$1,342.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$649.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$598.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$894.48
|
| Rate for Payer: Vantage Medical Group Senior |
$813.16
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$1,790.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$323.99 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$358.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,229.73
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cash Price |
$805.50
|
| 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 |
$323.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.50
|
| Rate for Payer: Multiplan Commercial |
$1,342.50
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$358.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,229.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$894.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$813.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| 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 |
$805.50
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cash Price |
$805.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$894.48
|
| Rate for Payer: Dignity Health Senior |
$813.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,163.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$813.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,108.01
|
| Rate for Payer: Heritage Provider Network Senior |
$1,000.19
|
| Rate for Payer: Humana Medicare |
$813.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$813.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,545.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$323.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$959.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,024.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,024.58
|
| Rate for Payer: Multiplan Commercial |
$1,342.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$894.48
|
| Rate for Payer: TriValley Medical Group Senior |
$813.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,600.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,188.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,219.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$894.48
|
| Rate for Payer: Vantage Medical Group Senior |
$813.16
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
IP
|
$4,668.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.91 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Adventist Health Commercial |
$933.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,206.92
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,160.24
|
| Rate for Payer: Heritage Provider Network Senior |
$3,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$844.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,167.00
|
| Rate for Payer: Multiplan Commercial |
$3,501.00
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
OP
|
$4,668.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$844.91 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$933.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,206.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cash Price |
$2,100.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,034.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,160.24
|
| Rate for Payer: Heritage Provider Network Senior |
$3,160.24
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,249.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$844.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,167.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$3,501.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,694.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,559.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC TESTICULAR SCAN
|
Facility
|
OP
|
$1,393.00
|
|
|
Service Code
|
CPT 78761
|
| Hospital Charge Code |
909301429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$134.97 |
| Max. Negotiated Rate |
$1,044.75 |
| Rate for Payer: Adventist Health Commercial |
$278.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$393.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$956.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Blue Shield of California Commercial |
$653.33
|
| Rate for Payer: Blue Shield of California EPN |
$371.53
|
| Rate for Payer: Cash Price |
$626.85
|
| Rate for Payer: Cash Price |
$626.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$905.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: Dignity Health Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$905.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$515.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$862.27
|
| Rate for Payer: Heritage Provider Network Senior |
$862.27
|
| Rate for Payer: Humana Medicare |
$515.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$134.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$979.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$608.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$649.30
|
| Rate for Payer: Multiplan Commercial |
$1,044.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$566.85
|
| Rate for Payer: TriValley Medical Group Senior |
$515.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC TESTICULAR SCAN
|
Facility
|
IP
|
$1,393.00
|
|
|
Service Code
|
CPT 78761
|
| Hospital Charge Code |
909301429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$252.13 |
| Max. Negotiated Rate |
$1,044.75 |
| Rate for Payer: Adventist Health Commercial |
$278.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$956.99
|
| Rate for Payer: Cash Price |
$626.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$943.06
|
| Rate for Payer: Heritage Provider Network Senior |
$943.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.25
|
| Rate for Payer: Multiplan Commercial |
$1,044.75
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$216.05 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$75.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.05
|
| Rate for Payer: Blue Shield of California Commercial |
$201.69
|
| Rate for Payer: Blue Shield of California EPN |
$157.67
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Senior |
$25.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Humana Medicare |
$25.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$35.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$49.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.52
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.81
|
| Rate for Payer: TriValley Medical Group Senior |
$25.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.88
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.75 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$211.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$208.52
|
| Rate for Payer: Heritage Provider Network Senior |
$208.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
|
|
HC TEST URINE VOLUME
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$66.75 |
| Rate for Payer: Adventist Health Commercial |
$17.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.14
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.25
|
| Rate for Payer: Heritage Provider Network Senior |
$60.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.25
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
|
|
HC TEST URINE VOLUME
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$23.42 |
| Rate for Payer: Adventist Health Commercial |
$2.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$8.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.30
|
| Rate for Payer: Blue Shield of California Commercial |
$23.42
|
| Rate for Payer: Blue Shield of California EPN |
$18.31
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.00
|
| Rate for Payer: Dignity Health Senior |
$3.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$3.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.81
|
| Rate for Payer: Heritage Provider Network Senior |
$6.81
|
| Rate for Payer: Humana Medicare |
$3.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.59
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.64
|
| Rate for Payer: TriValley Medical Group Senior |
$3.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3.64
|
|
|
HC TETRACYCLINE E TEST
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Adventist Health Commercial |
$2.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.88
|
| Rate for Payer: Blue Shield of California Commercial |
$22.47
|
| Rate for Payer: Blue Shield of California EPN |
$17.57
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.81
|
| Rate for Payer: Heritage Provider Network Senior |
$6.81
|
| Rate for Payer: Humana Medicare |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.98
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.75
|
| Rate for Payer: TriValley Medical Group Senior |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC TETRACYCLINE E TEST
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.55 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$74.20
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.12
|
| Rate for Payer: Heritage Provider Network Senior |
$73.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.00
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
|
|
HC THEOPHYLLINE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$118.45 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.45
|
| Rate for Payer: Blue Shield of California Commercial |
$110.51
|
| Rate for Payer: Blue Shield of California EPN |
$86.39
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.55
|
| Rate for Payer: Dignity Health Senior |
$14.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Humana Medicare |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.82
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.14
|
| Rate for Payer: TriValley Medical Group Senior |
$14.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Vantage Medical Group Senior |
$14.14
|
|
|
HC THEOPHYLLINE
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$40.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$140.15
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.11
|
| Rate for Payer: Heritage Provider Network Senior |
$138.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.00
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$198.36
|
| Rate for Payer: Heritage Provider Network Senior |
$198.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Senior |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.37
|
| Rate for Payer: Heritage Provider Network Senior |
$181.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$141.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$198.36
|
| Rate for Payer: Heritage Provider Network Senior |
$198.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Senior |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.37
|
| Rate for Payer: Heritage Provider Network Senior |
$181.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$141.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.80
|
| Rate for Payer: Heritage Provider Network Senior |
$117.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$147.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$147.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.90
|
| Rate for Payer: Dignity Health Senior |
$147.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.71
|
| Rate for Payer: Heritage Provider Network Senior |
$107.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$83.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.90
|
| Rate for Payer: Vantage Medical Group Senior |
$147.90
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.80
|
| Rate for Payer: Heritage Provider Network Senior |
$117.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$147.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$147.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.90
|
| Rate for Payer: Dignity Health Senior |
$147.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.71
|
| Rate for Payer: Heritage Provider Network Senior |
$107.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$83.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.90
|
| Rate for Payer: Vantage Medical Group Senior |
$147.90
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT COMM MCARE
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900419055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$198.36
|
| Rate for Payer: Heritage Provider Network Senior |
$198.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT COMM MCARE
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900419055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Senior |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.37
|
| Rate for Payer: Heritage Provider Network Senior |
$181.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$141.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
