|
HC SHILEY TRACHEO SOFT XLT PROXIMAL CUFFLESS 7.0
|
Facility
|
OP
|
$377.58
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800854
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$320.94 |
| Rate for Payer: Adventist Health Commercial |
$75.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$233.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$283.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.87
|
| Rate for Payer: Blue Shield of California Commercial |
$230.32
|
| Rate for Payer: Blue Shield of California EPN |
$184.26
|
| Rate for Payer: Cash Price |
$169.91
|
| Rate for Payer: Cigna of CA HMO/PPO |
$245.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$233.72
|
| Rate for Payer: Heritage Provider Network Senior |
$233.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$180.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$264.31
|
| Rate for Payer: Multiplan Commercial |
$283.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$188.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$188.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.94
|
| Rate for Payer: Vantage Medical Group Senior |
$320.94
|
|
|
HC SHILEY TRACHEO SOFT XLT PROXIMAL CUFFLESS 8.0
|
Facility
|
OP
|
$377.58
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$320.94 |
| Rate for Payer: Adventist Health Commercial |
$75.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$233.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$283.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.87
|
| Rate for Payer: Blue Shield of California Commercial |
$230.32
|
| Rate for Payer: Blue Shield of California EPN |
$184.26
|
| Rate for Payer: Cash Price |
$169.91
|
| Rate for Payer: Cigna of CA HMO/PPO |
$245.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$233.72
|
| Rate for Payer: Heritage Provider Network Senior |
$233.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$180.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$264.31
|
| Rate for Payer: Multiplan Commercial |
$283.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$188.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$188.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.94
|
| Rate for Payer: Vantage Medical Group Senior |
$320.94
|
|
|
HC SHILEY TRACHEO SOFT XLT PROXIMAL CUFFLESS 8.0
|
Facility
|
IP
|
$377.58
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$283.19 |
| Rate for Payer: Adventist Health Commercial |
$75.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$243.16
|
| Rate for Payer: Cash Price |
$169.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$255.62
|
| Rate for Payer: Heritage Provider Network Senior |
$255.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.39
|
| Rate for Payer: Multiplan Commercial |
$283.19
|
|
|
HC SHILEY TRACH TUBE
|
Facility
|
IP
|
$270.00
|
|
| Hospital Charge Code |
900800703
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.87 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$173.88
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.79
|
| Rate for Payer: Heritage Provider Network Senior |
$182.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
|
|
HC SHILEY TRACH TUBE
|
Facility
|
OP
|
$270.00
|
|
| Hospital Charge Code |
900800703
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.87 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.05
|
| Rate for Payer: Blue Shield of California Commercial |
$164.70
|
| Rate for Payer: Blue Shield of California EPN |
$131.76
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$175.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$229.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$167.13
|
| Rate for Payer: Heritage Provider Network Senior |
$167.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$128.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$135.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$135.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
|
HC SHOULDER ARTHROGRAPHY INJ
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
909000113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.02 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$107.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$331.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$455.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$402.00
|
| 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 |
$241.20
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$348.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$455.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$455.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$455.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$331.78
|
| Rate for Payer: Heritage Provider Network Senior |
$331.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$255.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$375.20
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$455.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$455.60
|
| Rate for Payer: Vantage Medical Group Senior |
$455.60
|
|
|
HC SHOULDER ARTHROGRAPHY INJ
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
909000113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.02 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Adventist Health Commercial |
$107.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$345.18
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$362.87
|
| Rate for Payer: Heritage Provider Network Senior |
$362.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.00
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
|
|
HC SHOULDER COMPLETE UNILAT
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
909001504
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$208.69 |
| Max. Negotiated Rate |
$864.75 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$742.53
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$780.58
|
| Rate for Payer: Heritage Provider Network Senior |
$780.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.25
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
|
|
HC SHOULDER COMPLETE UNILAT
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
909001504
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$864.75 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$712.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.95
|
| Rate for Payer: Blue Shield of California Commercial |
$120.91
|
| Rate for Payer: Blue Shield of California EPN |
$97.23
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$749.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$680.27
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$713.71
|
| Rate for Payer: Heritage Provider Network Senior |
$713.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$549.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.93
|
| Rate for Payer: TriValley Medical Group Senior |
$111.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC SHOULDER LIMITED
|
Facility
|
IP
|
$575.00
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
909001505
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$104.08 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$370.30
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$389.27
|
| Rate for Payer: Heritage Provider Network Senior |
$389.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.75
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
|
|
HC SHOULDER LIMITED
|
Facility
|
OP
|
$575.00
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
909001505
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$355.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.61
|
| Rate for Payer: Blue Shield of California Commercial |
$97.82
|
| Rate for Payer: Blue Shield of California EPN |
$78.67
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$373.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$355.93
|
| Rate for Payer: Heritage Provider Network Senior |
$355.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$274.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.93
|
| Rate for Payer: TriValley Medical Group Senior |
$111.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC SHUNT EVALUATION
|
Facility
|
IP
|
$1,578.00
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
909301415
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$285.62 |
| Max. Negotiated Rate |
$1,183.50 |
| Rate for Payer: Adventist Health Commercial |
$315.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,016.23
|
| Rate for Payer: Cash Price |
$710.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,068.31
|
| Rate for Payer: Heritage Provider Network Senior |
$1,068.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$285.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.50
|
| Rate for Payer: Multiplan Commercial |
$1,183.50
|
|
|
HC SHUNT EVALUATION
|
Facility
|
OP
|
$1,578.00
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
909301415
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$285.62 |
| Max. Negotiated Rate |
$1,183.50 |
| Rate for Payer: Adventist Health Commercial |
$315.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$975.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$698.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$789.32
|
| Rate for Payer: Blue Shield of California Commercial |
$720.86
|
| Rate for Payer: Blue Shield of California EPN |
$579.69
|
| Rate for Payer: Cash Price |
$710.10
|
| Rate for Payer: Cash Price |
$710.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,025.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$768.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,025.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$698.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$976.78
|
| Rate for Payer: Heritage Provider Network Senior |
$976.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$698.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$752.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$285.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$803.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$935.79
|
| Rate for Payer: Multiplan Commercial |
$1,183.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$768.18
|
| Rate for Payer: TriValley Medical Group Senior |
$698.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$789.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$789.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Vantage Medical Group Senior |
$698.35
|
|
|
HC SHUNTOGRAM
|
Facility
|
IP
|
$2,038.00
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
909001355
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$368.88 |
| Max. Negotiated Rate |
$1,528.50 |
| Rate for Payer: Adventist Health Commercial |
$407.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,312.47
|
| Rate for Payer: Cash Price |
$917.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,379.73
|
| Rate for Payer: Heritage Provider Network Senior |
$1,379.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$368.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.50
|
| Rate for Payer: Multiplan Commercial |
$1,528.50
|
|
|
HC SHUNTOGRAM
|
Facility
|
OP
|
$2,038.00
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
909001355
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$1,528.50 |
| Rate for Payer: Adventist Health Commercial |
$407.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,259.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$213.31
|
| Rate for Payer: Blue Shield of California Commercial |
$166.80
|
| Rate for Payer: Blue Shield of California EPN |
$134.13
|
| Rate for Payer: Cash Price |
$917.10
|
| Rate for Payer: Cash Price |
$917.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,324.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,202.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$134.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,261.52
|
| Rate for Payer: Heritage Provider Network Senior |
$1,261.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$972.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$368.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,528.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$134.46
|
| Rate for Payer: TriValley Medical Group Senior |
$134.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC SIALOGRAM
|
Facility
|
OP
|
$830.00
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
909001167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$150.23 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Adventist Health Commercial |
$166.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$512.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$482.80
|
| Rate for Payer: Blue Shield of California Commercial |
$377.47
|
| Rate for Payer: Blue Shield of California EPN |
$303.55
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$539.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$489.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$306.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$513.77
|
| Rate for Payer: Heritage Provider Network Senior |
$513.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$395.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$622.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$306.88
|
| Rate for Payer: TriValley Medical Group Senior |
$306.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$378.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$378.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC SIALOGRAM
|
Facility
|
IP
|
$830.00
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
909001167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$150.23 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Adventist Health Commercial |
$166.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$534.52
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$561.91
|
| Rate for Payer: Heritage Provider Network Senior |
$561.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.50
|
| Rate for Payer: Multiplan Commercial |
$622.50
|
|
|
HC SIALOGRAPHY DUCT DILATION
|
Facility
|
IP
|
$4,009.00
|
|
|
Service Code
|
CPT 42660
|
| Hospital Charge Code |
909000133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$725.63 |
| Max. Negotiated Rate |
$3,006.75 |
| Rate for Payer: Adventist Health Commercial |
$801.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,581.80
|
| Rate for Payer: Cash Price |
$1,804.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,714.09
|
| Rate for Payer: Heritage Provider Network Senior |
$2,714.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$725.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,002.25
|
| Rate for Payer: Multiplan Commercial |
$3,006.75
|
|
|
HC SIALOGRAPHY DUCT DILATION
|
Facility
|
OP
|
$4,009.00
|
|
|
Service Code
|
CPT 42660
|
| Hospital Charge Code |
909000133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$693.67 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$801.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,477.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| 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 |
$1,804.05
|
| Rate for Payer: Cash Price |
$1,804.05
|
| Rate for Payer: Cash Price |
$1,804.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,605.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$693.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,481.57
|
| Rate for Payer: Heritage Provider Network Senior |
$853.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,317.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$725.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$797.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,002.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$3,006.75
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: TriValley Medical Group Commercial |
$763.04
|
| Rate for Payer: TriValley Medical Group Senior |
$763.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC SIALOGRAPHY INJECTION
|
Facility
|
OP
|
$349.00
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
909000132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$69.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$215.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$296.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$261.75
|
| 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 |
$157.05
|
| Rate for Payer: Cash Price |
$157.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$226.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$296.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$296.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$296.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$216.03
|
| Rate for Payer: Heritage Provider Network Senior |
$216.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$166.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$244.30
|
| Rate for Payer: Multiplan Commercial |
$261.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$296.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$296.65
|
| Rate for Payer: Vantage Medical Group Senior |
$296.65
|
|
|
HC SIALOGRAPHY INJECTION
|
Facility
|
IP
|
$349.00
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
909000132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Adventist Health Commercial |
$69.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$224.76
|
| Rate for Payer: Cash Price |
$157.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$236.27
|
| Rate for Payer: Heritage Provider Network Senior |
$236.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.25
|
| Rate for Payer: Multiplan Commercial |
$261.75
|
|
|
HC SIALOLITHOTOMY, SUBMANDIBULAR
|
Facility
|
OP
|
$4,906.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
900501646
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$887.99 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$981.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,031.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,330.35
|
| Rate for Payer: Blue Shield of California EPN |
$1,854.47
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,188.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,264.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,321.36
|
| Rate for Payer: Heritage Provider Network Senior |
$3,321.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,340.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$887.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,903.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$3,679.50
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,943.60
|
| Rate for Payer: TriValley Medical Group Senior |
$2,943.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC SIALOLITHOTOMY, SUBMANDIBULAR
|
Facility
|
IP
|
$4,906.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
900501646
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$887.99 |
| Max. Negotiated Rate |
$3,679.50 |
| Rate for Payer: Adventist Health Commercial |
$981.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,159.46
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,321.36
|
| Rate for Payer: Heritage Provider Network Senior |
$3,321.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$887.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.50
|
| Rate for Payer: Multiplan Commercial |
$3,679.50
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.82
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$64.99
|
| Rate for Payer: Heritage Provider Network Senior |
$64.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$59.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.54
|
| Rate for Payer: Blue Shield of California Commercial |
$44.41
|
| Rate for Payer: Blue Shield of California Commercial |
$44.41
|
| Rate for Payer: Blue Shield of California EPN |
$35.62
|
| Rate for Payer: Blue Shield of California EPN |
$35.62
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$38.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$62.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.81
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.51
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$36.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$59.42
|
| Rate for Payer: Heritage Provider Network Senior |
$36.52
|
| Rate for Payer: Heritage Provider Network Senior |
$59.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$45.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.51
|
| Rate for Payer: TriValley Medical Group Senior |
$5.51
|
| Rate for Payer: TriValley Medical Group Senior |
$5.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.95
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
|
