|
HC SOM PCDEC GFAP IFA
|
Facility
|
OP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.07
|
| Rate for Payer: Heritage Provider Network Senior |
$31.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDEC GFAP IFA
|
Facility
|
IP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.98
|
| Rate for Payer: Heritage Provider Network Senior |
$33.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
|
|
HC SOM PCDEC LGI1-IGG CBA
|
Facility
|
OP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915448
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.07
|
| Rate for Payer: Heritage Provider Network Senior |
$31.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDEC LGI1-IGG CBA
|
Facility
|
IP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915448
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.98
|
| Rate for Payer: Heritage Provider Network Senior |
$33.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
|
|
HC SOM PCDEC MGLUR1 AB IFA
|
Facility
|
OP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915450
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.07
|
| Rate for Payer: Heritage Provider Network Senior |
$31.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDEC MGLUR1 AB IFA
|
Facility
|
IP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915450
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.98
|
| Rate for Payer: Heritage Provider Network Senior |
$33.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
|
|
HC SOM PCDEC NMDA-R AB CBA
|
Facility
|
OP
|
$50.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915445
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.63
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.07
|
| Rate for Payer: Heritage Provider Network Senior |
$31.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$37.65
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDEC NMDA-R AB CBA
|
Facility
|
IP
|
$50.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915445
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$37.65 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.99
|
| Rate for Payer: Heritage Provider Network Senior |
$33.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Multiplan Commercial |
$37.65
|
|
|
HC SOM PCDEC NMO/AQP4 FACS
|
Facility
|
IP
|
$157.17
|
|
|
Service Code
|
CPT 86053
|
| Hospital Charge Code |
900915447
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.45 |
| Max. Negotiated Rate |
$117.88 |
| Rate for Payer: Adventist Health Commercial |
$31.43
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.40
|
| Rate for Payer: Heritage Provider Network Senior |
$106.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.29
|
| Rate for Payer: Multiplan Commercial |
$117.88
|
|
|
HC SOM PCDEC NMO/AQP4 FACS
|
Facility
|
OP
|
$157.17
|
|
|
Service Code
|
CPT 86053
|
| Hospital Charge Code |
900915447
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$117.88 |
| Rate for Payer: Adventist Health Commercial |
$31.43
|
| Rate for Payer: Aetna of CA Gatekeeper |
$84.01
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$107.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.98
|
| Rate for Payer: Blue Shield of California Commercial |
$69.41
|
| Rate for Payer: Blue Shield of California EPN |
$55.67
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cash Price |
$157.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$102.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.50
|
| Rate for Payer: Dignity Health Senior |
$37.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.16
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$97.29
|
| Rate for Payer: Heritage Provider Network Senior |
$97.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$74.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.54
|
| Rate for Payer: Multiplan Commercial |
$117.88
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.73
|
| Rate for Payer: TriValley Medical Group Senior |
$37.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Vantage Medical Group Senior |
$37.73
|
|
|
HC SOM PCDEC PCA-TR
|
Facility
|
OP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915443
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.07
|
| Rate for Payer: Heritage Provider Network Senior |
$31.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDEC PCA-TR
|
Facility
|
IP
|
$50.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915443
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$10.04
|
| Rate for Payer: Cash Price |
$50.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.98
|
| Rate for Payer: Heritage Provider Network Senior |
$33.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.55
|
| Rate for Payer: Multiplan Commercial |
$37.64
|
|
|
HC SOM PCDES AMPA-R AB CBA
|
Facility
|
IP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$36.49 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.94
|
| Rate for Payer: Heritage Provider Network Senior |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
|
|
HC SOM PCDES AMPA-R AB CBA
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDES ANNA1
|
Facility
|
IP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915489
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$36.49 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.94
|
| Rate for Payer: Heritage Provider Network Senior |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
|
|
HC SOM PCDES ANNA1
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915489
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDES CASPR2 IGG CBA
|
Facility
|
IP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915495
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$36.49 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.94
|
| Rate for Payer: Heritage Provider Network Senior |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
|
|
HC SOM PCDES CASPR2 IGG CBA
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915495
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDES DPPX AB CBA
|
Facility
|
IP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915498
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$36.49 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.94
|
| Rate for Payer: Heritage Provider Network Senior |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
|
|
HC SOM PCDES DPPX AB CBA
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915498
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDES GABA-B-R AB CBA
|
Facility
|
IP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915492
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$36.49 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.94
|
| Rate for Payer: Heritage Provider Network Senior |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
|
|
HC SOM PCDES GABA-B-R AB CBA
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915492
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM PCDES GAD65 AB
|
Facility
|
OP
|
$95.16
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915487
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.22 |
| Max. Negotiated Rate |
$140.38 |
| Rate for Payer: Adventist Health Commercial |
$19.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$50.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.38
|
| Rate for Payer: Blue Shield of California Commercial |
$133.75
|
| Rate for Payer: Blue Shield of California EPN |
$107.28
|
| Rate for Payer: Cash Price |
$95.16
|
| Rate for Payer: Cash Price |
$95.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Senior |
$23.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.90
|
| Rate for Payer: Heritage Provider Network Senior |
$58.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$45.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.70
|
| Rate for Payer: Multiplan Commercial |
$71.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$23.57
|
| Rate for Payer: TriValley Medical Group Senior |
$23.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC SOM PCDES GAD65 AB
|
Facility
|
IP
|
$95.16
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915487
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.22 |
| Max. Negotiated Rate |
$71.37 |
| Rate for Payer: Adventist Health Commercial |
$19.03
|
| Rate for Payer: Cash Price |
$95.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$64.42
|
| Rate for Payer: Heritage Provider Network Senior |
$64.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.79
|
| Rate for Payer: Multiplan Commercial |
$71.37
|
|
|
HC SOM PCDES GFAP IFA
|
Facility
|
OP
|
$48.65
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915499
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$9.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cash Price |
$48.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.11
|
| Rate for Payer: Heritage Provider Network Senior |
$30.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$36.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
