|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
OP
|
$1,496.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.29 |
| Max. Negotiated Rate |
$3,517.28 |
| Rate for Payer: Adventist Health Commercial |
$299.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,027.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,271.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$822.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,122.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$972.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,271.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,271.60
|
| Rate for Payer: Dignity Health Senior |
$1,271.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$897.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$926.02
|
| Rate for Payer: Heritage Provider Network Senior |
$926.02
|
| Rate for Payer: IEHP Medi-Cal |
$124.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$721.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$374.00
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,271.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,271.60
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
IP
|
$512.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.67 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$351.74
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$346.62
|
| Rate for Payer: Heritage Provider Network Senior |
$346.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.00
|
| Rate for Payer: Multiplan Commercial |
$384.00
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
OP
|
$512.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.74 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$51.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$351.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.70
|
| Rate for Payer: Blue Shield of California Commercial |
$133.09
|
| Rate for Payer: Blue Shield of California EPN |
$75.68
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$332.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: Dignity Health Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$137.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$316.93
|
| Rate for Payer: Heritage Provider Network Senior |
$316.93
|
| Rate for Payer: Humana Medicare |
$137.36
|
| Rate for Payer: IEHP Medi-Cal |
$43.74
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$260.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.07
|
| Rate for Payer: Multiplan Commercial |
$384.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$137.36
|
| Rate for Payer: TriValley Medical Group Senior |
$137.36
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
IP
|
$646.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.93 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Adventist Health Commercial |
$129.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.80
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$437.34
|
| Rate for Payer: Heritage Provider Network Senior |
$437.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.50
|
| Rate for Payer: Multiplan Commercial |
$484.50
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
OP
|
$646.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$48.09 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Adventist Health Commercial |
$129.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$60.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$443.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.94
|
| Rate for Payer: Blue Shield of California Commercial |
$152.15
|
| Rate for Payer: Blue Shield of California EPN |
$86.52
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Cash Price |
$290.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$419.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: Dignity Health Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$137.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$399.87
|
| Rate for Payer: Heritage Provider Network Senior |
$399.87
|
| Rate for Payer: Humana Medicare |
$137.36
|
| Rate for Payer: IEHP Medi-Cal |
$48.09
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$260.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.07
|
| Rate for Payer: Multiplan Commercial |
$484.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$137.36
|
| Rate for Payer: TriValley Medical Group Senior |
$137.36
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
OP
|
$692.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.77 |
| Max. Negotiated Rate |
$519.00 |
| Rate for Payer: Adventist Health Commercial |
$138.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$75.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$475.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.53
|
| Rate for Payer: Blue Shield of California Commercial |
$186.87
|
| Rate for Payer: Blue Shield of California EPN |
$106.26
|
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$449.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: Dignity Health Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$449.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$137.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$428.35
|
| Rate for Payer: Heritage Provider Network Senior |
$428.35
|
| Rate for Payer: Humana Medicare |
$137.36
|
| Rate for Payer: IEHP Medi-Cal |
$54.77
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$260.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.07
|
| Rate for Payer: Multiplan Commercial |
$519.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$137.36
|
| Rate for Payer: TriValley Medical Group Senior |
$137.36
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
IP
|
$692.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$125.25 |
| Max. Negotiated Rate |
$519.00 |
| Rate for Payer: Adventist Health Commercial |
$138.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$475.40
|
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$468.48
|
| Rate for Payer: Heritage Provider Network Senior |
$468.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Multiplan Commercial |
$519.00
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
IP
|
$5,333.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$965.27 |
| Max. Negotiated Rate |
$3,999.75 |
| Rate for Payer: Adventist Health Commercial |
$1,066.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,663.77
|
| Rate for Payer: Cash Price |
$2,399.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,610.44
|
| Rate for Payer: Heritage Provider Network Senior |
$3,610.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.25
|
| Rate for Payer: Multiplan Commercial |
$3,999.75
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
OP
|
$5,333.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.24 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$1,066.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,663.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,533.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,933.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,999.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$2,399.85
|
| Rate for Payer: Cash Price |
$2,399.85
|
| Rate for Payer: Cash Price |
$2,399.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,466.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,533.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,533.05
|
| Rate for Payer: Dignity Health Senior |
$4,533.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,301.13
|
| Rate for Payer: Heritage Provider Network Senior |
$3,301.13
|
| Rate for Payer: IEHP Medi-Cal |
$174.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,570.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.25
|
| Rate for Payer: Multiplan Commercial |
$3,999.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,533.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,533.05
|
|
|
HC THROMBECTOMY CATH, 6&7F HYDROL
|
Facility
OP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$288.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$691.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$989.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$792.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,080.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$894.24
|
| Rate for Payer: Blue Shield of California EPN |
$845.28
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$662.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,224.00
|
| Rate for Payer: Dignity Health Senior |
$1,224.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$921.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$666.72
|
| Rate for Payer: Heritage Provider Network Senior |
$666.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$720.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$525.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$481.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,224.00
|
|
|
HC THROMBECTOMY CATH, 6&7F HYDROL
|
Facility
IP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$288.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$691.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$989.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$662.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$777.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$974.88
|
| Rate for Payer: Heritage Provider Network Senior |
$974.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$720.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$525.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$481.10
|
|
|
HC THROMBIN TIME
|
Facility
IP
|
$194.00
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
900910021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$35.11 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$133.28
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$131.34
|
| Rate for Payer: Heritage Provider Network Senior |
$131.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.50
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
|
|
HC THROMBIN TIME
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
900910021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$48.41 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.41
|
| Rate for Payer: Blue Shield of California Commercial |
$45.11
|
| Rate for Payer: Blue Shield of California EPN |
$35.27
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.35
|
| Rate for Payer: Dignity Health Senior |
$5.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Humana Medicare |
$5.77
|
| Rate for Payer: IEHP Medi-Cal |
$7.78
|
| Rate for Payer: IEHP Medicare Advantage |
$5.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.27
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.77
|
| Rate for Payer: TriValley Medical Group Senior |
$5.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.23
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5.77
|
|
|
HC THROMBOELASTOGRAPH
|
Facility
IP
|
$561.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$101.54 |
| Max. Negotiated Rate |
$420.75 |
| Rate for Payer: Adventist Health Commercial |
$112.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$385.41
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$379.80
|
| Rate for Payer: Heritage Provider Network Senior |
$379.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.25
|
| Rate for Payer: Multiplan Commercial |
$420.75
|
|
|
HC THROMBOELASTOGRAPH
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$134.23 |
| Rate for Payer: Adventist Health Commercial |
$14.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.67
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$55.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.23
|
| Rate for Payer: Blue Shield of California Commercial |
$45.95
|
| Rate for Payer: Blue Shield of California EPN |
$43.44
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$62.90
|
| Rate for Payer: Dignity Health Senior |
$62.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.81
|
| Rate for Payer: Heritage Provider Network Senior |
$45.81
|
| Rate for Payer: IEHP Medi-Cal |
$27.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.50
|
| Rate for Payer: Multiplan Commercial |
$55.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.90
|
| Rate for Payer: Vantage Medical Group Senior |
$62.90
|
|
|
HC THROMBOLYSIS ART
|
Facility
OP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
906820230
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$512.26 |
| Max. Negotiated Rate |
$13,045.53 |
| Rate for Payer: Adventist Health Commercial |
$986.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,387.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,062.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,894.50
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,205.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: Dignity Health Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,866.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,052.29
|
| Rate for Payer: Heritage Provider Network Senior |
$3,052.29
|
| Rate for Payer: Humana Medicare |
$6,866.07
|
| Rate for Payer: IEHP Medi-Cal |
$512.26
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,045.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$892.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,101.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,651.25
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,866.07
|
| Rate for Payer: TriValley Medical Group Senior |
$6,866.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC THROMBOLYSIS ART
|
Facility
IP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
906820230
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$892.51 |
| Max. Negotiated Rate |
$3,698.25 |
| Rate for Payer: Adventist Health Commercial |
$986.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,387.60
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,338.29
|
| Rate for Payer: Heritage Provider Network Senior |
$3,338.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$892.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.75
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
|
|
HC THROMBOLYSIS ART
|
Facility
IP
|
$4,012.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$726.17 |
| Max. Negotiated Rate |
$3,009.00 |
| Rate for Payer: Adventist Health Commercial |
$802.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,756.24
|
| Rate for Payer: Cash Price |
$1,805.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,716.12
|
| Rate for Payer: Heritage Provider Network Senior |
$2,716.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$726.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,003.00
|
| Rate for Payer: Multiplan Commercial |
$3,009.00
|
|
|
HC THROMBOLYSIS ART
|
Facility
OP
|
$4,012.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$512.26 |
| Max. Negotiated Rate |
$13,045.53 |
| Rate for Payer: Adventist Health Commercial |
$802.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,756.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,491.45
|
| Rate for Payer: Blue Shield of California EPN |
$2,355.04
|
| Rate for Payer: Cash Price |
$1,805.40
|
| Rate for Payer: Cash Price |
$1,805.40
|
| Rate for Payer: Cash Price |
$1,805.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,607.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: Dignity Health Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$6,866.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,483.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,483.43
|
| Rate for Payer: Humana Medicare |
$6,866.07
|
| Rate for Payer: IEHP Medi-Cal |
$512.26
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,045.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$726.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,101.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,003.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,651.25
|
| Rate for Payer: Multiplan Commercial |
$3,009.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$6,866.07
|
| Rate for Payer: TriValley Medical Group Senior |
$6,866.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
IP
|
$10,312.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
906820227
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,866.47 |
| Max. Negotiated Rate |
$7,734.00 |
| Rate for Payer: Adventist Health Commercial |
$2,062.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,084.34
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,981.22
|
| Rate for Payer: Heritage Provider Network Senior |
$6,981.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,866.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,578.00
|
| Rate for Payer: Multiplan Commercial |
$7,734.00
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
OP
|
$9,146.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
909020157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.44 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,829.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,283.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,679.67
|
| Rate for Payer: Blue Shield of California EPN |
$5,368.70
|
| Rate for Payer: Cash Price |
$4,115.70
|
| Rate for Payer: Cash Price |
$4,115.70
|
| Rate for Payer: Cash Price |
$4,115.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,944.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,661.37
|
| Rate for Payer: Heritage Provider Network Senior |
$5,661.37
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$186.44
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,655.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,286.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$6,859.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
OP
|
$10,312.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
906820227
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.44 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,062.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,084.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,403.75
|
| Rate for Payer: Blue Shield of California EPN |
$6,053.14
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,702.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,383.13
|
| Rate for Payer: Heritage Provider Network Senior |
$6,383.13
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$186.44
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,866.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,578.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$7,734.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
IP
|
$9,146.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
909020157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,655.43 |
| Max. Negotiated Rate |
$6,859.50 |
| Rate for Payer: Adventist Health Commercial |
$1,829.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,283.30
|
| Rate for Payer: Cash Price |
$4,115.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,191.84
|
| Rate for Payer: Heritage Provider Network Senior |
$6,191.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,655.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,286.50
|
| Rate for Payer: Multiplan Commercial |
$6,859.50
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
OP
|
$1,512.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906820029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$273.67 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$921.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,038.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,285.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$831.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,134.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,285.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,285.20
|
| Rate for Payer: Dignity Health Senior |
$1,285.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$935.93
|
| Rate for Payer: Heritage Provider Network Senior |
$935.93
|
| Rate for Payer: IEHP Medi-Cal |
$525.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$728.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$273.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$378.00
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,285.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,285.20
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
OP
|
$1,580.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906811110
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$285.98 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$316.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$921.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,085.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,343.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$869.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,185.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$711.00
|
| Rate for Payer: Cash Price |
$711.00
|
| Rate for Payer: Cash Price |
$711.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,343.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,343.00
|
| Rate for Payer: Dignity Health Senior |
$1,343.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$978.02
|
| Rate for Payer: Heritage Provider Network Senior |
$978.02
|
| Rate for Payer: IEHP Medi-Cal |
$525.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$761.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$285.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.00
|
| Rate for Payer: Multiplan Commercial |
$1,185.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,343.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,343.00
|
|
