|
HC TOTAL BODY THYROID SCAN
|
Facility
IP
|
$2,761.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$499.74 |
| Max. Negotiated Rate |
$2,070.75 |
| Rate for Payer: Adventist Health Commercial |
$552.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,896.81
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,869.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1,869.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.25
|
| Rate for Payer: Multiplan Commercial |
$2,070.75
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$202.49 |
| Max. Negotiated Rate |
$2,070.75 |
| Rate for Payer: Adventist Health Commercial |
$552.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$616.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,896.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,109.45
|
| Rate for Payer: Blue Shield of California EPN |
$630.91
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,794.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.86
|
| Rate for Payer: Dignity Health Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,794.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$675.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,709.06
|
| Rate for Payer: Heritage Provider Network Senior |
$1,709.06
|
| Rate for Payer: Humana Medicare |
$675.33
|
| Rate for Payer: IEHP Medi-Cal |
$202.49
|
| Rate for Payer: IEHP Medicare Advantage |
$675.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,283.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$850.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$850.92
|
| Rate for Payer: Multiplan Commercial |
$2,070.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$742.86
|
| Rate for Payer: TriValley Medical Group Senior |
$675.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
IP
|
$553.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Adventist Health Commercial |
$110.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$379.91
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$374.38
|
| Rate for Payer: Heritage Provider Network Senior |
$374.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.25
|
| Rate for Payer: Multiplan Commercial |
$414.75
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
OP
|
$553.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$110.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$223.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$379.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.41
|
| Rate for Payer: Blue Shield of California EPN |
$324.61
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$359.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: Dignity Health Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$335.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$342.31
|
| Rate for Payer: Heritage Provider Network Senior |
$342.31
|
| Rate for Payer: Humana Medicare |
$335.55
|
| Rate for Payer: IEHP Medi-Cal |
$213.14
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$637.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$422.79
|
| Rate for Payer: Multiplan Commercial |
$414.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$369.10
|
| Rate for Payer: TriValley Medical Group Senior |
$369.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
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 |
$717.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,352.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,082.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,476.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,222.13
|
| Rate for Payer: Blue Shield of California EPN |
$1,155.22
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| 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 |
$948.58
|
| 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
|
| Rate for Payer: TriValley Medical Group Commercial |
$984.00
|
| Rate for Payer: TriValley Medical Group Senior |
$984.00
|
| 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: Aetna of CA Non-Gatekeeper |
$1,352.02
|
| Rate for Payer: Cash Price |
$885.60
|
| 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
|
$210.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.01 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$144.27
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.17
|
| Rate for Payer: Heritage Provider Network Senior |
$142.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.08
|
| Rate for Payer: Blue Shield of California Commercial |
$112.41
|
| Rate for Payer: Blue Shield of California EPN |
$87.88
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.04
|
| Rate for Payer: Heritage Provider Network Senior |
$34.04
|
| Rate for Payer: Humana Medicare |
$14.39
|
| Rate for Payer: IEHP Medi-Cal |
$19.95
|
| Rate for Payer: IEHP Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.75
|
| 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 |
$41.25
|
| 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 |
$21.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.01 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$144.27
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$142.17
|
| Rate for Payer: Heritage Provider Network Senior |
$142.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$124.65 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.65
|
| Rate for Payer: Blue Shield of California Commercial |
$112.47
|
| Rate for Payer: Blue Shield of California EPN |
$87.92
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.04
|
| Rate for Payer: Heritage Provider Network Senior |
$34.04
|
| Rate for Payer: Humana Medicare |
$14.41
|
| Rate for Payer: IEHP Medi-Cal |
$19.97
|
| Rate for Payer: IEHP Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.75
|
| 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 |
$41.25
|
| 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 |
$21.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Adventist Health Commercial |
$11.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.85
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.27
|
| Rate for Payer: Heritage Provider Network Senior |
$39.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.50
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.08
|
| Rate for Payer: Blue Shield of California Commercial |
$112.41
|
| Rate for Payer: Blue Shield of California EPN |
$87.88
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.14
|
| Rate for Payer: Heritage Provider Network Senior |
$24.14
|
| Rate for Payer: Humana Medicare |
$14.39
|
| Rate for Payer: IEHP Medi-Cal |
$19.95
|
| Rate for Payer: IEHP Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.75
|
| 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 |
$29.25
|
| 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 |
$21.58
|
| 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
|
$58.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Adventist Health Commercial |
$11.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.85
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.27
|
| Rate for Payer: Heritage Provider Network Senior |
$39.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.50
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$124.65 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.65
|
| Rate for Payer: Blue Shield of California Commercial |
$112.47
|
| Rate for Payer: Blue Shield of California EPN |
$87.92
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.14
|
| Rate for Payer: Heritage Provider Network Senior |
$24.14
|
| Rate for Payer: Humana Medicare |
$14.41
|
| Rate for Payer: IEHP Medi-Cal |
$19.97
|
| Rate for Payer: IEHP Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.75
|
| 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 |
$29.25
|
| 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 |
$21.62
|
| 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
IP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$12,173.00 |
| 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: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| 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 |
$280.28
|
| Rate for Payer: Heritage Provider Network Senior |
$280.28
|
| 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 |
$150.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.32
|
|
|
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 |
$12,139.00 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$227.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$310.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$257.09
|
| Rate for Payer: Blue Shield of California EPN |
$243.02
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| 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: Multiplan Commercial |
$310.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$150.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$138.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.90
|
| Rate for Payer: Vantage Medical Group Senior |
$351.90
|
|
|
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 |
$12,173.00 |
| 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: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$177.12
|
| Rate for Payer: Cash Price |
$177.12
|
| 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 |
$266.47
|
| Rate for Payer: Heritage Provider Network Senior |
$266.47
|
| 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 |
$143.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.50
|
|
|
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 |
$12,139.00 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$334.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$295.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$244.43
|
| Rate for Payer: Blue Shield of California EPN |
$231.04
|
| Rate for Payer: Cash Price |
$177.12
|
| Rate for Payer: Cash Price |
$177.12
|
| 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: Multiplan Commercial |
$295.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$143.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$131.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.56
|
| Rate for Payer: Vantage Medical Group Senior |
$334.56
|
|
|
HC TRACH CHANGE
|
Facility
IP
|
$1,322.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$239.28 |
| Max. Negotiated Rate |
$991.50 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$908.21
|
| Rate for Payer: Cash Price |
$594.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$894.99
|
| Rate for Payer: Heritage Provider Network Senior |
$894.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
|
|
HC TRACH CHANGE
|
Facility
OP
|
$1,322.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$991.50 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$706.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$908.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Blue Shield of California Commercial |
$820.96
|
| Rate for Payer: Blue Shield of California EPN |
$776.01
|
| Rate for Payer: Cash Price |
$594.90
|
| Rate for Payer: Cash Price |
$594.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$859.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: Dignity Health Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$195.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$818.32
|
| Rate for Payer: Heritage Provider Network Senior |
$818.32
|
| Rate for Payer: Humana Medicare |
$195.17
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$370.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$330.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.91
|
| Rate for Payer: Multiplan Commercial |
$991.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$214.69
|
| Rate for Payer: TriValley Medical Group Senior |
$195.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
OP
|
$2,935.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.84 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$587.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,016.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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 |
$1,320.75
|
| Rate for Payer: Cash Price |
$1,320.75
|
| Rate for Payer: Cash Price |
$1,320.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,907.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: Dignity Health Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$687.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,816.76
|
| Rate for Payer: Heritage Provider Network Senior |
$845.55
|
| Rate for Payer: Humana Medicare |
$687.44
|
| Rate for Payer: IEHP Medi-Cal |
$264.84
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,306.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$811.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$733.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.17
|
| Rate for Payer: Multiplan Commercial |
$2,201.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$756.18
|
| Rate for Payer: TriValley Medical Group Senior |
$756.18
|
| 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 Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
IP
|
$2,935.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.24 |
| Max. Negotiated Rate |
$2,201.25 |
| Rate for Payer: Adventist Health Commercial |
$587.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,016.34
|
| Rate for Payer: Cash Price |
$1,320.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,987.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1,987.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$733.75
|
| Rate for Payer: Multiplan Commercial |
$2,201.25
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
OP
|
$2,522.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$504.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,732.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,639.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,707.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,707.39
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,215.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$630.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$1,891.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$915.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$842.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
OP
|
$2,522.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$504.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,732.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,639.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: Dignity Health Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$305.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,561.12
|
| Rate for Payer: Heritage Provider Network Senior |
$375.38
|
| Rate for Payer: Humana Medicare |
$305.19
|
| Rate for Payer: IEHP Medi-Cal |
$313.62
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$579.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$360.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$630.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.54
|
| Rate for Payer: Multiplan Commercial |
$1,891.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$335.71
|
| Rate for Payer: TriValley Medical Group Senior |
$335.71
|
| 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 Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
IP
|
$2,522.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.48 |
| Max. Negotiated Rate |
$1,891.50 |
| Rate for Payer: Adventist Health Commercial |
$504.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,732.61
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,707.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,707.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$630.50
|
| Rate for Payer: Multiplan Commercial |
$1,891.50
|
|
