|
HC TOMOGRAPHY SINGLE PLANE BODY SEC
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 76100
|
| Hospital Charge Code |
909001551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.52 |
| Max. Negotiated Rate |
$648.75 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$462.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$594.25
|
| 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 |
$328.46
|
| Rate for Payer: Blue Shield of California Commercial |
$262.61
|
| Rate for Payer: Blue Shield of California EPN |
$211.18
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$562.25
|
| 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 |
$562.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$535.43
|
| Rate for Payer: Heritage Provider Network Senior |
$535.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$412.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.25
|
| 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 |
$648.75
|
| 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 TOMOGRAPHY SINGLE PLANE BODY SEC
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 76100
|
| Hospital Charge Code |
909001551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.56 |
| Max. Negotiated Rate |
$648.75 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$585.61
|
| Rate for Payer: Heritage Provider Network Senior |
$585.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.25
|
| Rate for Payer: Multiplan Commercial |
$648.75
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
IP
|
$3,016.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$545.90 |
| Max. Negotiated Rate |
$2,262.00 |
| Rate for Payer: Adventist Health Commercial |
$603.20
|
| Rate for Payer: Cash Price |
$1,658.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,041.83
|
| Rate for Payer: Heritage Provider Network Senior |
$2,041.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$545.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$754.00
|
| Rate for Payer: Multiplan Commercial |
$2,262.00
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
OP
|
$3,016.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.28 |
| Max. Negotiated Rate |
$2,262.00 |
| Rate for Payer: Adventist Health Commercial |
$603.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,612.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,071.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Blue Shield of California Commercial |
$1,142.78
|
| Rate for Payer: Blue Shield of California EPN |
$918.99
|
| Rate for Payer: Cash Price |
$1,658.80
|
| Rate for Payer: Cash Price |
$1,658.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,960.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Senior |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,960.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$683.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,866.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,866.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$210.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,438.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$545.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$786.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$754.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$861.75
|
| Rate for Payer: Multiplan Commercial |
$2,262.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$752.32
|
| Rate for Payer: TriValley Medical Group Senior |
$683.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,508.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,508.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
OP
|
$604.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.32 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$120.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$322.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$368.44
|
| Rate for Payer: Blue Shield of California EPN |
$294.75
|
| Rate for Payer: Cash Price |
$332.20
|
| Rate for Payer: Cash Price |
$332.20
|
| Rate for Payer: Cash Price |
$332.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$392.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Senior |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$337.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$373.88
|
| Rate for Payer: Heritage Provider Network Senior |
$373.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$221.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$288.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$388.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$425.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.19
|
| Rate for Payer: Multiplan Commercial |
$453.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$371.19
|
| Rate for Payer: TriValley Medical Group Senior |
$371.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$302.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$302.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
IP
|
$604.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.32 |
| Max. Negotiated Rate |
$453.00 |
| Rate for Payer: Adventist Health Commercial |
$120.80
|
| Rate for Payer: Cash Price |
$332.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.91
|
| Rate for Payer: Heritage Provider Network Senior |
$408.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.00
|
| Rate for Payer: Multiplan Commercial |
$453.00
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
OP
|
$1,968.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$356.21 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,051.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,352.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,082.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,476.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,200.48
|
| Rate for Payer: Blue Shield of California EPN |
$960.38
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,279.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,672.80
|
| Rate for Payer: Dignity Health Senior |
$1,672.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,218.19
|
| Rate for Payer: Heritage Provider Network Senior |
$1,218.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$938.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,377.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,377.60
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$984.00
|
| Rate for Payer: TriValley Medical Group Senior |
$984.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,672.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,672.80
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
IP
|
$1,968.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$356.21 |
| Max. Negotiated Rate |
$1,476.00 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,332.34
|
| Rate for Payer: Heritage Provider Network Senior |
$1,332.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$148.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$190.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.98
|
| Rate for Payer: Blue Shield of California Commercial |
$115.83
|
| Rate for Payer: Blue Shield of California EPN |
$92.91
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$132.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.13
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.39
|
| Rate for Payer: TriValley Medical Group Senior |
$14.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$148.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$190.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.96
|
| Rate for Payer: Blue Shield of California Commercial |
$115.89
|
| Rate for Payer: Blue Shield of California EPN |
$92.95
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$132.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.16
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.41
|
| Rate for Payer: TriValley Medical Group Senior |
$14.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$152.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.25 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$90.72
|
| Rate for Payer: Heritage Provider Network Senior |
$90.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$130.98 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$71.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.98
|
| Rate for Payer: Blue Shield of California Commercial |
$115.83
|
| Rate for Payer: Blue Shield of California EPN |
$92.91
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.95
|
| Rate for Payer: Heritage Provider Network Senior |
$82.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$63.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.13
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.39
|
| Rate for Payer: TriValley Medical Group Senior |
$14.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.25 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$90.72
|
| Rate for Payer: Heritage Provider Network Senior |
$90.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$135.96 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$71.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$92.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.96
|
| Rate for Payer: Blue Shield of California Commercial |
$115.89
|
| Rate for Payer: Blue Shield of California EPN |
$92.95
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.95
|
| Rate for Payer: Heritage Provider Network Senior |
$82.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$63.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.16
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.41
|
| Rate for Payer: TriValley Medical Group Senior |
$14.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$198.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$284.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$227.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$310.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$166.43
|
| Rate for Payer: Blue Shield of California EPN |
$166.43
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$351.90
|
| Rate for Payer: Dignity Health Senior |
$351.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$191.68
|
| Rate for Payer: Heritage Provider Network Senior |
$191.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$207.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$149.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.90
|
| Rate for Payer: Vantage Medical Group Senior |
$351.90
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$198.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$166.43
|
| Rate for Payer: Blue Shield of California EPN |
$166.43
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$223.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$191.68
|
| Rate for Payer: Heritage Provider Network Senior |
$191.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$207.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.50
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$149.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.08
|
|
|
HC TPN/QUINTON CATH SIMPLE
|
Facility
|
OP
|
$393.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$78.72
|
| Rate for Payer: Aetna of CA Gatekeeper |
$188.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$270.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$158.23
|
| Rate for Payer: Blue Shield of California EPN |
$158.23
|
| Rate for Payer: Cash Price |
$216.48
|
| Rate for Payer: Cash Price |
$216.48
|
| Rate for Payer: Cigna of CA HMO/PPO |
$181.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.56
|
| Rate for Payer: Dignity Health Senior |
$334.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.24
|
| Rate for Payer: Heritage Provider Network Senior |
$182.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$196.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$196.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.52
|
| Rate for Payer: Multiplan Commercial |
$295.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$142.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$130.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.56
|
| Rate for Payer: Vantage Medical Group Senior |
$334.56
|
|
|
HC TPN/QUINTON CATH SIMPLE
|
Facility
|
IP
|
$393.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$78.72
|
| Rate for Payer: Aetna of CA Gatekeeper |
$188.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$158.23
|
| Rate for Payer: Blue Shield of California EPN |
$158.23
|
| Rate for Payer: Cash Price |
$216.48
|
| Rate for Payer: Cash Price |
$216.48
|
| Rate for Payer: Cigna of CA HMO/PPO |
$181.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.24
|
| Rate for Payer: Heritage Provider Network Senior |
$182.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$196.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$196.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: Multiplan Commercial |
$295.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$142.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$130.32
|
|
|
HC TRACH CHANGE
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$209.96 |
| Max. Negotiated Rate |
$870.00 |
| Rate for Payer: Adventist Health Commercial |
$232.00
|
| Rate for Payer: Cash Price |
$638.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$785.32
|
| Rate for Payer: Heritage Provider Network Senior |
$785.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.00
|
| Rate for Payer: Multiplan Commercial |
$870.00
|
|
|
HC TRACH CHANGE
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$870.00 |
| Rate for Payer: Adventist Health Commercial |
$232.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$620.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$796.92
|
| 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 |
$707.60
|
| Rate for Payer: Blue Shield of California EPN |
$566.08
|
| Rate for Payer: Cash Price |
$638.00
|
| Rate for Payer: Cash Price |
$638.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$754.00
|
| 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 |
$754.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$198.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$718.04
|
| Rate for Payer: Heritage Provider Network Senior |
$718.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$553.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.00
|
| 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 |
$870.00
|
| 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 |
$580.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$580.00
|
| 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 TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
|
IP
|
$3,206.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.29 |
| Max. Negotiated Rate |
$2,404.50 |
| Rate for Payer: Adventist Health Commercial |
$641.20
|
| Rate for Payer: Cash Price |
$1,763.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,170.46
|
| Rate for Payer: Heritage Provider Network Senior |
$2,170.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$580.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.50
|
| Rate for Payer: Multiplan Commercial |
$2,404.50
|
|
|
HC TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
|
OP
|
$3,206.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$641.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,202.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| 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 |
$1,763.30
|
| Rate for Payer: Cash Price |
$1,763.30
|
| Rate for Payer: Cash Price |
$1,763.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,083.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Senior |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$647.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,984.51
|
| Rate for Payer: Heritage Provider Network Senior |
$795.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$275.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,229.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$580.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$744.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.28
|
| Rate for Payer: Multiplan Commercial |
$2,404.50
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: TriValley Medical Group Commercial |
$711.75
|
| Rate for Payer: TriValley Medical Group Senior |
$711.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
|
OP
|
$3,335.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$667.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,291.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| 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 |
$1,834.25
|
| Rate for Payer: Cash Price |
$1,834.25
|
| Rate for Payer: Cash Price |
$1,834.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,167.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Senior |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$295.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,064.36
|
| Rate for Payer: Heritage Provider Network Senior |
$362.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$325.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$560.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$603.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.78
|
| Rate for Payer: Multiplan Commercial |
$2,501.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$324.57
|
| Rate for Payer: TriValley Medical Group Senior |
$324.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
