|
HC SUBSTERN ICD DFIB TEST
|
Facility
|
IP
|
$4,286.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906820278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$775.77 |
| Max. Negotiated Rate |
$3,214.50 |
| Rate for Payer: Adventist Health Commercial |
$857.20
|
| Rate for Payer: Cash Price |
$2,357.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,901.62
|
| Rate for Payer: Heritage Provider Network Senior |
$2,901.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$775.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,071.50
|
| Rate for Payer: Multiplan Commercial |
$3,214.50
|
|
|
HC SUBSTERN ICD DFIB TEST
|
Facility
|
IP
|
$3,643.00
|
|
|
Service Code
|
CPT 0577T
|
| Hospital Charge Code |
906810577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$659.38 |
| Max. Negotiated Rate |
$2,732.25 |
| Rate for Payer: Adventist Health Commercial |
$728.60
|
| Rate for Payer: Cash Price |
$2,003.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,466.31
|
| Rate for Payer: Heritage Provider Network Senior |
$2,466.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$659.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$910.75
|
| Rate for Payer: Multiplan Commercial |
$2,732.25
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51,988.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$49,188.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Senior |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,842.82
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19,979.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,249.48
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,567.01
|
| Rate for Payer: TriValley Medical Group Senior |
$11,567.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
OP
|
$58,366.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,097.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Senior |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$10,515.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,128.55
|
| Rate for Payer: Heritage Provider Network Senior |
$12,934.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19,979.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,092.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,249.48
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$11,567.01
|
| Rate for Payer: TriValley Medical Group Senior |
$11,567.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
IP
|
$58,366.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906810572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,564.25 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,513.78
|
| Rate for Payer: Heritage Provider Network Senior |
$39,513.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
|
|
HC SUBSTERN ICD LEAD INSERT
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0572T
|
| Hospital Charge Code |
906820275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,697.17 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$51,231.97
|
| Rate for Payer: Heritage Provider Network Senior |
$51,231.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51,988.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$49,188.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,842.82
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
OP
|
$58,366.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,097.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,128.55
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
IP
|
$58,366.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906810573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,564.25 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,513.78
|
| Rate for Payer: Heritage Provider Network Senior |
$39,513.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
|
|
HC SUBSTERN ICD LEAD REMOVE
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0573T
|
| Hospital Charge Code |
906820276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,697.17 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$51,231.97
|
| Rate for Payer: Heritage Provider Network Senior |
$51,231.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906820277
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51,988.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$49,188.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,842.82
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
OP
|
$58,366.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906810574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,097.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,128.55
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906820277
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,697.17 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$51,231.97
|
| Rate for Payer: Heritage Provider Network Senior |
$51,231.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
|
|
HC SUBSTERN ICD LEAD REPOS
|
Facility
|
IP
|
$58,366.00
|
|
|
Service Code
|
CPT 0574T
|
| Hospital Charge Code |
906810574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,564.25 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,513.78
|
| Rate for Payer: Heritage Provider Network Senior |
$39,513.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906810580
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,304.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,126.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,977.39
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$870.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
OP
|
$5,659.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906820279
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,887.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| 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 |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,678.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Senior |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,624.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,502.92
|
| Rate for Payer: Heritage Provider Network Senior |
$5,687.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,785.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,024.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,317.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,414.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,826.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,826.35
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,086.50
|
| Rate for Payer: TriValley Medical Group Senior |
$5,086.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
IP
|
$5,659.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906820279
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,024.28 |
| Max. Negotiated Rate |
$4,244.25 |
| Rate for Payer: Adventist Health Commercial |
$1,131.80
|
| Rate for Payer: Cash Price |
$3,112.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,831.14
|
| Rate for Payer: Heritage Provider Network Senior |
$3,831.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,024.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,414.75
|
| Rate for Payer: Multiplan Commercial |
$4,244.25
|
|
|
HC SUBSTERN ICD REMOVE
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 0580T
|
| Hospital Charge Code |
906810580
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$3,607.50 |
| Rate for Payer: Adventist Health Commercial |
$962.00
|
| Rate for Payer: Cash Price |
$2,645.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,256.37
|
| Rate for Payer: Heritage Provider Network Senior |
$3,256.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$870.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.50
|
| Rate for Payer: Multiplan Commercial |
$3,607.50
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906820274
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51,988.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$49,188.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,842.82
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
OP
|
$58,366.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906810571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,097.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,128.55
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906820274
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,697.17 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$51,231.97
|
| Rate for Payer: Heritage Provider Network Senior |
$51,231.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
|
|
HC SUBSTERN LEAD W/ICD INST/REPL
|
Facility
|
IP
|
$58,366.00
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
906810571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,564.25 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,513.78
|
| Rate for Payer: Heritage Provider Network Senior |
$39,513.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
|
|
HC SUDAN BLACK B
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900910057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$114.75 |
| Max. Negotiated Rate |
$475.50 |
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$429.22
|
| Rate for Payer: Heritage Provider Network Senior |
$429.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.50
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
|
|
HC SUDAN BLACK B
|
Facility
|
OP
|
$634.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900910057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.55 |
| Max. Negotiated Rate |
$475.50 |
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$338.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$435.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.55
|
| Rate for Payer: Blue Shield of California Commercial |
$199.39
|
| Rate for Payer: Blue Shield of California EPN |
$160.34
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Cash Price |
$348.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$412.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Senior |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$163.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$392.45
|
| Rate for Payer: Heritage Provider Network Senior |
$392.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$55.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$302.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.36
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$163.78
|
| Rate for Payer: TriValley Medical Group Senior |
$163.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC SUPERION IDS 10MM
|
Facility
|
OP
|
$34,225.00
|
|
|
Service Code
|
CPT C1821
|
| Hospital Charge Code |
909001823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,845.00 |
| Max. Negotiated Rate |
$29,091.25 |
| Rate for Payer: Adventist Health Commercial |
$6,845.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16,428.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23,512.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29,091.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18,823.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25,668.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,758.45
|
| Rate for Payer: Blue Shield of California EPN |
$13,758.45
|
| Rate for Payer: Cash Price |
$18,823.75
|
| Rate for Payer: Cash Price |
$18,823.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,743.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29,091.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$29,091.25
|
| Rate for Payer: Dignity Health Senior |
$29,091.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,904.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,846.17
|
| Rate for Payer: Heritage Provider Network Senior |
$15,846.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17,112.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,112.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,112.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,556.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,957.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,957.50
|
| Rate for Payer: Multiplan Commercial |
$25,668.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12,365.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,331.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29,091.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29,091.25
|
| Rate for Payer: Vantage Medical Group Senior |
$29,091.25
|
|
