|
HC TRACTION MECHANICAL MCARE COMM
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900407037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.09 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$45.51
|
| Rate for Payer: Aetna of CA Gatekeeper |
$59.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$76.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$61.05
|
| Rate for Payer: Cash Price |
$61.05
|
| Rate for Payer: Cash Price |
$61.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$72.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.35
|
| Rate for Payer: Dignity Health Senior |
$94.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.71
|
| Rate for Payer: Heritage Provider Network Senior |
$68.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$52.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.70
|
| Rate for Payer: Multiplan Commercial |
$83.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.35
|
| Rate for Payer: Vantage Medical Group Senior |
$94.35
|
|
|
HC TRACTION MECHANICAL MCARE COMM
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900407037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.09 |
| Max. Negotiated Rate |
$83.25 |
| Rate for Payer: Adventist Health Commercial |
$22.20
|
| Rate for Payer: Cash Price |
$61.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.15
|
| Rate for Payer: Heritage Provider Network Senior |
$75.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.75
|
| Rate for Payer: Multiplan Commercial |
$83.25
|
|
|
HC TRANSABD AMNIOINFUSION ADDL FETUS
|
Facility
|
OP
|
$891.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400089
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$178.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$612.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$543.51
|
| Rate for Payer: Blue Shield of California EPN |
$434.81
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Senior |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$386.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$551.53
|
| Rate for Payer: Heritage Provider Network Senior |
$551.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$536.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$425.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$444.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$222.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.99
|
| Rate for Payer: Multiplan Commercial |
$668.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$445.50
|
| Rate for Payer: TriValley Medical Group Senior |
$445.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$445.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$445.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC TRANSABD AMNIOINFUSION ADDL FETUS
|
Facility
|
IP
|
$891.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400089
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$161.27 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Adventist Health Commercial |
$178.20
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$603.21
|
| Rate for Payer: Heritage Provider Network Senior |
$603.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$222.75
|
| Rate for Payer: Multiplan Commercial |
$668.25
|
|
|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
|
IP
|
$1,025.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$185.53 |
| Max. Negotiated Rate |
$768.75 |
| Rate for Payer: Adventist Health Commercial |
$205.00
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$693.92
|
| Rate for Payer: Heritage Provider Network Senior |
$693.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.25
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
|
|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
|
OP
|
$1,025.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$205.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$704.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$625.25
|
| Rate for Payer: Blue Shield of California EPN |
$500.20
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Cash Price |
$563.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Senior |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$386.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.48
|
| Rate for Payer: Heritage Provider Network Senior |
$634.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$536.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$488.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$444.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.99
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$512.50
|
| Rate for Payer: TriValley Medical Group Senior |
$512.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$512.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$512.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
OP
|
$3,327.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$665.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,285.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,029.47
|
| Rate for Payer: Blue Shield of California EPN |
$1,623.58
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,162.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Senior |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,684.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,059.41
|
| Rate for Payer: Heritage Provider Network Senior |
$2,059.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$341.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,586.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,387.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,902.65
|
| Rate for Payer: Multiplan Commercial |
$2,495.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,153.10
|
| Rate for Payer: TriValley Medical Group Senior |
$5,153.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,663.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,663.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
IP
|
$3,327.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$602.19 |
| Max. Negotiated Rate |
$2,495.25 |
| Rate for Payer: Adventist Health Commercial |
$665.40
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,252.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,252.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.75
|
| Rate for Payer: Multiplan Commercial |
$2,495.25
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
OP
|
$3,327.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$665.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,285.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| 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 |
$1,829.85
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,162.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Senior |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,684.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,059.41
|
| Rate for Payer: Heritage Provider Network Senior |
$5,762.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$341.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,900.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,387.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,902.65
|
| Rate for Payer: Multiplan Commercial |
$2,495.25
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,153.10
|
| Rate for Payer: TriValley Medical Group Senior |
$5,153.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
IP
|
$3,327.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$602.19 |
| Max. Negotiated Rate |
$2,495.25 |
| Rate for Payer: Adventist Health Commercial |
$665.40
|
| Rate for Payer: Cash Price |
$1,829.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,252.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,252.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.75
|
| Rate for Payer: Multiplan Commercial |
$2,495.25
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,061.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,650.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,250.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,830.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,464.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,950.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,550.00
|
| Rate for Payer: Dignity Health Senior |
$2,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,857.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$95.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,100.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,100.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,500.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,500.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,500.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,500.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,550.00
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Senior |
$2,031.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Senior |
$2,031.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,061.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,650.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,250.00
|
| 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 |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,950.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,550.00
|
| Rate for Payer: Dignity Health Senior |
$2,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,857.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$95.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,100.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,100.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
| 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 |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,550.00
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,061.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,650.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,250.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,830.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,464.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,950.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,550.00
|
| Rate for Payer: Dignity Health Senior |
$2,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,857.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$118.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,100.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,100.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,500.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,500.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,500.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,500.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,550.00
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Senior |
$2,031.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,061.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,650.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,250.00
|
| 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 |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,950.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,550.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,550.00
|
| Rate for Payer: Dignity Health Senior |
$2,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,857.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$118.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,100.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,100.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
| 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 |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,550.00
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Senior |
$2,031.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Senior |
$2,031.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$600.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,061.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| 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 |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cash Price |
$1,650.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,950.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Senior |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,684.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Senior |
$5,762.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$301.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,900.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,387.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,902.65
|
| Rate for Payer: Multiplan Commercial |
$2,250.00
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$5,153.10
|
| Rate for Payer: TriValley Medical Group Senior |
$5,153.10
|
| 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 |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25,207.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,849.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,712.35
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$978.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,641.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,173.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$27,519.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$22,815.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$31,046.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$6,209.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,328.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$17,075.30
|
| Rate for Payer: Cash Price |
$17,075.30
|
| Rate for Payer: Cash Price |
$17,075.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,179.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,217.47
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$978.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,619.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,761.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$23,284.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$22,815.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$27,519.00 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,641.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,173.00
|
| Rate for Payer: Multiplan Commercial |
$27,519.00
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$31,046.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$23,284.50 |
| Rate for Payer: Adventist Health Commercial |
$6,209.20
|
| Rate for Payer: Cash Price |
$17,075.30
|
| Rate for Payer: Cash Price |
$17,075.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,619.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,761.50
|
| Rate for Payer: Multiplan Commercial |
$23,284.50
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$26,558.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$5,311.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,245.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,354.00
|
| 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 |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Senior |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,262.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,439.40
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,232.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43,350.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,807.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,639.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,747.92
|
| Rate for Payer: Multiplan Commercial |
$19,918.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$22,815.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,767.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,783.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
