|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,158.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$209.60 |
| Max. Negotiated Rate |
$868.50 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$783.97
|
| Rate for Payer: Heritage Provider Network Senior |
$783.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.50
|
| Rate for Payer: Multiplan Commercial |
$868.50
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,158.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.60 |
| Max. Negotiated Rate |
$868.50 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$783.97
|
| Rate for Payer: Heritage Provider Network Senior |
$783.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.50
|
| Rate for Payer: Multiplan Commercial |
$868.50
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,184.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,067.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,908.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,968.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,082.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$132.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,671.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$575.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$967.91
|
| Rate for Payer: TriValley Medical Group Senior |
$967.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$575.58 |
| Max. Negotiated Rate |
$2,385.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,152.86
|
| Rate for Payer: Heritage Provider Network Senior |
$2,152.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$575.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,158.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$795.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$636.90
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$752.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$694.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$716.80
|
| Rate for Payer: Heritage Provider Network Senior |
$1,082.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$132.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,671.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$868.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$967.91
|
| Rate for Payer: TriValley Medical Group Senior |
$967.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,158.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$795.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Cash Price |
$636.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$752.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$752.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$783.97
|
| Rate for Payer: Heritage Provider Network Senior |
$783.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$552.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$868.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$416.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$383.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$239.28 |
| Max. Negotiated Rate |
$991.50 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$894.99
|
| Rate for Payer: Heritage Provider Network Senior |
$894.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$239.28 |
| Max. Negotiated Rate |
$991.50 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$894.99
|
| Rate for Payer: Heritage Provider Network Senior |
$894.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$239.28 |
| Max. Negotiated Rate |
$991.50 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$894.99
|
| Rate for Payer: Heritage Provider Network Senior |
$894.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$908.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| 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 |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$859.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$818.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,082.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$133.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,671.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$967.91
|
| Rate for Payer: TriValley Medical Group Senior |
$967.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$908.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$806.42
|
| Rate for Payer: Blue Shield of California EPN |
$645.14
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$859.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$818.32
|
| Rate for Payer: Heritage Provider Network Senior |
$818.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$133.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$630.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$967.91
|
| Rate for Payer: TriValley Medical Group Senior |
$879.92
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,322.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3,531.00 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$908.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cash Price |
$727.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$859.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Senior |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$879.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$894.99
|
| Rate for Payer: Heritage Provider Network Senior |
$894.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$630.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,011.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,108.70
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$475.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$437.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINE 2-3 VIEWS
|
Facility
|
OP
|
$797.00
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
909001302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$597.75 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$426.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$547.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.22
|
| Rate for Payer: Blue Shield of California Commercial |
$126.96
|
| Rate for Payer: Blue Shield of California EPN |
$102.10
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$518.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$518.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$493.34
|
| Rate for Payer: Heritage Provider Network Senior |
$493.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$380.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| 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 |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC SPINE 2-3 VIEWS
|
Facility
|
IP
|
$797.00
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
909001302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.26 |
| Max. Negotiated Rate |
$597.75 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$539.57
|
| Rate for Payer: Heritage Provider Network Senior |
$539.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.25
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
|
|
HC SPINE MINIMUM 4 VIEWS
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
909001301
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$693.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$891.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.60
|
| Rate for Payer: Blue Shield of California Commercial |
$188.45
|
| Rate for Payer: Blue Shield of California EPN |
$151.54
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$843.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$843.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$802.84
|
| Rate for Payer: Heritage Provider Network Senior |
$802.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$64.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$618.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| 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 |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC SPINE MINIMUM 4 VIEWS
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
909001301
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.76 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Cash Price |
$713.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$878.07
|
| Rate for Payer: Heritage Provider Network Senior |
$878.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.25
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
|
|
HC SPINE SCAN
|
Facility
|
IP
|
$1,120.00
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
906601401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$202.72 |
| Max. Negotiated Rate |
$840.00 |
| Rate for Payer: Adventist Health Commercial |
$224.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$758.24
|
| Rate for Payer: Heritage Provider Network Senior |
$758.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$840.00
|
|
|
HC SPINE SCAN
|
Facility
|
OP
|
$1,120.00
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
906601401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$131.19 |
| Max. Negotiated Rate |
$840.00 |
| Rate for Payer: Adventist Health Commercial |
$224.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$598.64
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$769.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Blue Shield of California Commercial |
$300.43
|
| Rate for Payer: Blue Shield of California EPN |
$241.60
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$728.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$728.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$693.28
|
| Rate for Payer: Heritage Provider Network Senior |
$693.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$131.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$534.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$840.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$154.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$154.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC SPINE SINGLE VIEW
|
Facility
|
IP
|
$563.00
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
909001325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$101.90 |
| Max. Negotiated Rate |
$422.25 |
| Rate for Payer: Adventist Health Commercial |
$112.60
|
| Rate for Payer: Cash Price |
$309.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$381.15
|
| Rate for Payer: Heritage Provider Network Senior |
$381.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.75
|
| Rate for Payer: Multiplan Commercial |
$422.25
|
|
|
HC SPINE SINGLE VIEW
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
909001325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.03 |
| Max. Negotiated Rate |
$422.25 |
| Rate for Payer: Adventist Health Commercial |
$112.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$300.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$386.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$85.73
|
| Rate for Payer: Blue Shield of California EPN |
$68.94
|
| Rate for Payer: Cash Price |
$309.65
|
| Rate for Payer: Cash Price |
$309.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$365.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$365.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$348.50
|
| Rate for Payer: Heritage Provider Network Senior |
$348.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$268.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$422.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| 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 |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC SPIROMETRY STUDIES
|
Facility
|
IP
|
$456.00
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
900801001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$82.54 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Adventist Health Commercial |
$91.20
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$308.71
|
| Rate for Payer: Heritage Provider Network Senior |
$308.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.00
|
| Rate for Payer: Multiplan Commercial |
$342.00
|
|
|
HC SPIROMETRY STUDIES
|
Facility
|
OP
|
$456.00
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
900801001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$39.85 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Adventist Health Commercial |
$91.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$243.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$313.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Blue Shield of California Commercial |
$128.11
|
| Rate for Payer: Blue Shield of California EPN |
$103.02
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$296.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Senior |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$282.26
|
| Rate for Payer: Heritage Provider Network Senior |
$282.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$217.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$250.49
|
| Rate for Payer: Multiplan Commercial |
$342.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$218.68
|
| Rate for Payer: TriValley Medical Group Senior |
$198.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$228.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$228.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC SPLINT FINGER BASEBALL 4.25 MD
|
Facility
|
IP
|
$8.19
|
|
|
Service Code
|
CPT A4570
|
| Hospital Charge Code |
901698379
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$6.14 |
| Rate for Payer: Adventist Health Commercial |
$1.64
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.54
|
| Rate for Payer: Heritage Provider Network Senior |
$5.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Multiplan Commercial |
$6.14
|
|
|
HC SPLINT FINGER BASEBALL 4.25 MD
|
Facility
|
OP
|
$8.19
|
|
|
Service Code
|
CPT A4570
|
| Hospital Charge Code |
901698379
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Adventist Health Commercial |
$1.64
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.14
|
| Rate for Payer: Blue Shield of California Commercial |
$5.00
|
| Rate for Payer: Blue Shield of California EPN |
$4.00
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.96
|
| Rate for Payer: Dignity Health Senior |
$6.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.07
|
| Rate for Payer: Heritage Provider Network Senior |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.73
|
| Rate for Payer: Multiplan Commercial |
$6.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.96
|
| Rate for Payer: Vantage Medical Group Senior |
$6.96
|
|
|
HC SPLINT FINGER BASEBALL 5 LG
|
Facility
|
OP
|
$8.19
|
|
|
Service Code
|
CPT A4570
|
| Hospital Charge Code |
901698380
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Adventist Health Commercial |
$1.64
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.14
|
| Rate for Payer: Blue Shield of California Commercial |
$5.00
|
| Rate for Payer: Blue Shield of California EPN |
$4.00
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.96
|
| Rate for Payer: Dignity Health Senior |
$6.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.07
|
| Rate for Payer: Heritage Provider Network Senior |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.73
|
| Rate for Payer: Multiplan Commercial |
$6.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.96
|
| Rate for Payer: Vantage Medical Group Senior |
$6.96
|
|
