|
HC SSB AB
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$144.59 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Adventist Health Commercial |
$34.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$105.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.59
|
| Rate for Payer: Blue Shield of California Commercial |
$144.35
|
| Rate for Payer: Blue Shield of California Commercial |
$144.35
|
| Rate for Payer: Blue Shield of California EPN |
$115.78
|
| Rate for Payer: Blue Shield of California EPN |
$115.78
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$105.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.24
|
| Rate for Payer: Heritage Provider Network Senior |
$105.85
|
| Rate for Payer: Heritage Provider Network Senior |
$27.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$81.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC SSB AB
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.95 |
| Max. Negotiated Rate |
$128.25 |
| Rate for Payer: Adventist Health Commercial |
$34.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.12
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$115.77
|
| Rate for Payer: Heritage Provider Network Senior |
$115.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.75
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
|
|
HC STAPHAUREX MRSA NON-BILLABLE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912440
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$44.43 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.43
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$23.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STAPHAUREX MRSA NON-BILLABLE
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912440
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.20
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.85
|
| Rate for Payer: Heritage Provider Network Senior |
$33.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
|
|
HC STDZD COG PERF TESTING PER HOUR
|
Facility
|
OP
|
$212.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
905606125
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$471.00 |
| Rate for Payer: Adventist Health Commercial |
$42.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$131.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$116.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.04
|
| Rate for Payer: Blue Shield of California Commercial |
$129.32
|
| Rate for Payer: Blue Shield of California EPN |
$103.46
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$137.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$131.23
|
| Rate for Payer: Heritage Provider Network Senior |
$131.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$101.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$148.40
|
| Rate for Payer: Multiplan Commercial |
$159.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$471.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.20
|
| Rate for Payer: Vantage Medical Group Senior |
$180.20
|
|
|
HC STDZD COG PERF TESTING PER HOUR
|
Facility
|
IP
|
$212.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
905606125
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Adventist Health Commercial |
$42.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$136.53
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$143.52
|
| Rate for Payer: Heritage Provider Network Senior |
$143.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Multiplan Commercial |
$159.00
|
|
|
HC STEERABLE GW
|
Facility
|
OP
|
$398.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.04 |
| Max. Negotiated Rate |
$338.30 |
| Rate for Payer: Adventist Health Commercial |
$79.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$245.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$298.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$199.08
|
| Rate for Payer: Blue Shield of California Commercial |
$242.78
|
| Rate for Payer: Blue Shield of California EPN |
$194.22
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$258.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$338.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$338.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$234.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$246.36
|
| Rate for Payer: Heritage Provider Network Senior |
$246.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$189.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$278.60
|
| Rate for Payer: Multiplan Commercial |
$298.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$199.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$199.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$338.30
|
| Rate for Payer: Vantage Medical Group Senior |
$338.30
|
|
|
HC STEERABLE GW
|
Facility
|
IP
|
$398.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.04 |
| Max. Negotiated Rate |
$298.50 |
| Rate for Payer: Adventist Health Commercial |
$79.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$256.31
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$269.45
|
| Rate for Payer: Heritage Provider Network Senior |
$269.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.50
|
| Rate for Payer: Multiplan Commercial |
$298.50
|
|
|
HC STENT BILIARY SMART CORIDS 2-6
|
Facility
|
OP
|
$2,880.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909081208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$576.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,779.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,448.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,584.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,160.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,157.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,157.76
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,324.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,448.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,448.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,448.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,843.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,333.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,333.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,440.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,440.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,440.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,016.00
|
| Rate for Payer: Multiplan Commercial |
$2,160.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$953.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,448.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,448.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,448.00
|
|
|
HC STENT BILIARY SMART CORIDS 2-6
|
Facility
|
IP
|
$2,880.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909081208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$576.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,854.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,157.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,157.76
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,555.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,333.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,333.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,440.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,440.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,440.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$720.00
|
| Rate for Payer: Multiplan Commercial |
$2,160.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$953.57
|
|
|
HC STENT CAROTID UNCVRD
|
Facility
|
OP
|
$6,825.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,365.00 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$1,365.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,217.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,801.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,753.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,118.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,743.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,743.65
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,139.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,801.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,801.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,801.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,368.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,159.97
|
| Rate for Payer: Heritage Provider Network Senior |
$3,159.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,412.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,412.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,412.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,706.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,777.50
|
| Rate for Payer: Multiplan Commercial |
$5,118.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,465.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,259.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,801.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,801.25
|
| Rate for Payer: Vantage Medical Group Senior |
$5,801.25
|
|
|
HC STENT CAROTID UNCVRD
|
Facility
|
IP
|
$6,825.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,365.00 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$1,365.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,395.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,743.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,743.65
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,139.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,685.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,159.97
|
| Rate for Payer: Heritage Provider Network Senior |
$3,159.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,412.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,412.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,412.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,706.25
|
| Rate for Payer: Multiplan Commercial |
$5,118.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,465.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,259.76
|
|
|
HC STENT, CCA W EPD
|
Facility
|
IP
|
$23,575.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
909080026
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,267.07 |
| Max. Negotiated Rate |
$17,681.25 |
| Rate for Payer: Adventist Health Commercial |
$4,715.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,182.30
|
| Rate for Payer: Cash Price |
$10,608.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,960.27
|
| Rate for Payer: Heritage Provider Network Senior |
$15,960.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,267.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,893.75
|
| Rate for Payer: Multiplan Commercial |
$17,681.25
|
|
|
HC STENT, CCA W EPD
|
Facility
|
OP
|
$23,575.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
909080026
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$20,038.75 |
| Rate for Payer: Adventist Health Commercial |
$4,715.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,569.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,038.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,966.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,681.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,136.00
|
| 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 |
$10,608.75
|
| Rate for Payer: Cash Price |
$10,608.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,323.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,038.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,038.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20,038.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,592.92
|
| Rate for Payer: Heritage Provider Network Senior |
$14,592.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$11,245.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,267.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,893.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16,502.50
|
| Rate for Payer: Multiplan Commercial |
$17,681.25
|
| 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 |
$20,038.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,038.75
|
| Rate for Payer: Vantage Medical Group Senior |
$20,038.75
|
|
|
HC STENT CCA W/O EPD
|
Facility
|
IP
|
$27,549.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
909080027
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,986.37 |
| Max. Negotiated Rate |
$20,661.75 |
| Rate for Payer: Adventist Health Commercial |
$5,509.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,741.56
|
| Rate for Payer: Cash Price |
$12,397.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,650.67
|
| Rate for Payer: Heritage Provider Network Senior |
$18,650.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,986.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,887.25
|
| Rate for Payer: Multiplan Commercial |
$20,661.75
|
|
|
HC STENT CCA W/O EPD
|
Facility
|
OP
|
$27,549.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
909080027
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$23,416.65 |
| Rate for Payer: Adventist Health Commercial |
$5,509.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,025.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,416.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,151.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,661.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,435.00
|
| 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 |
$12,397.05
|
| Rate for Payer: Cash Price |
$12,397.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,906.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,416.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,416.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,416.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,052.83
|
| Rate for Payer: Heritage Provider Network Senior |
$17,052.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,140.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,986.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,887.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,284.30
|
| Rate for Payer: Multiplan Commercial |
$20,661.75
|
| 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 |
$23,416.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,416.65
|
| Rate for Payer: Vantage Medical Group Senior |
$23,416.65
|
|
|
HC STENT COARCT BRNCH ENDGRFT INCL LSCA
|
Facility
|
OP
|
$27,843.00
|
|
|
Service Code
|
CPT 33882
|
| Hospital Charge Code |
906811870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,039.58 |
| Max. Negotiated Rate |
$23,666.55 |
| Rate for Payer: Adventist Health Commercial |
$5,568.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,206.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,666.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,313.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,882.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$12,529.35
|
| Rate for Payer: Cash Price |
$12,529.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,097.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,666.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,666.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,666.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,234.82
|
| Rate for Payer: Heritage Provider Network Senior |
$17,234.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,281.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,039.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,960.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,490.10
|
| Rate for Payer: Multiplan Commercial |
$20,882.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,921.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13,921.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,666.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,666.55
|
| Rate for Payer: Vantage Medical Group Senior |
$23,666.55
|
|
|
HC STENT COARCT BRNCH ENDGRFT INCL LSCA
|
Facility
|
IP
|
$27,843.00
|
|
|
Service Code
|
CPT 33882
|
| Hospital Charge Code |
906811870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,039.58 |
| Max. Negotiated Rate |
$20,882.25 |
| Rate for Payer: Adventist Health Commercial |
$5,568.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,930.89
|
| Rate for Payer: Cash Price |
$12,529.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,849.71
|
| Rate for Payer: Heritage Provider Network Senior |
$18,849.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,039.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,960.75
|
| Rate for Payer: Multiplan Commercial |
$20,882.25
|
|
|
HC STENT COARCT INCLUDING LSCA
|
Facility
|
OP
|
$4,791.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906811485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$867.17 |
| Max. Negotiated Rate |
$12,185.00 |
| Rate for Payer: Adventist Health Commercial |
$958.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,960.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,072.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,635.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,593.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,155.95
|
| Rate for Payer: Cash Price |
$2,155.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,114.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,072.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,072.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,072.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,965.63
|
| Rate for Payer: Heritage Provider Network Senior |
$2,965.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,285.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$867.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,197.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,353.70
|
| Rate for Payer: Multiplan Commercial |
$3,593.25
|
| 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 |
$4,072.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,072.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4,072.35
|
|
|
HC STENT COARCT INCLUDING LSCA
|
Facility
|
IP
|
$4,791.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906811485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$867.17 |
| Max. Negotiated Rate |
$3,593.25 |
| Rate for Payer: Adventist Health Commercial |
$958.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,085.40
|
| Rate for Payer: Cash Price |
$2,155.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,243.51
|
| Rate for Payer: Heritage Provider Network Senior |
$3,243.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$867.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,197.75
|
| Rate for Payer: Multiplan Commercial |
$3,593.25
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
|
IP
|
$27,843.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906811493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,039.58 |
| Max. Negotiated Rate |
$20,882.25 |
| Rate for Payer: Adventist Health Commercial |
$5,568.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,930.89
|
| Rate for Payer: Cash Price |
$12,529.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,849.71
|
| Rate for Payer: Heritage Provider Network Senior |
$18,849.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,039.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,960.75
|
| Rate for Payer: Multiplan Commercial |
$20,882.25
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
|
OP
|
$27,843.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906811493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$23,666.55 |
| Rate for Payer: Adventist Health Commercial |
$5,568.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,206.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,666.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,313.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,882.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$12,529.35
|
| Rate for Payer: Cash Price |
$12,529.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,097.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,666.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,666.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,666.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,234.82
|
| Rate for Payer: Heritage Provider Network Senior |
$17,234.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13,281.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,039.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,960.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,490.10
|
| Rate for Payer: Multiplan Commercial |
$20,882.25
|
| 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 |
$23,666.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,666.55
|
| Rate for Payer: Vantage Medical Group Senior |
$23,666.55
|
|
|
HC STENT COVERED I CAST
|
Facility
|
IP
|
$6,437.50
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909020087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,287.50 |
| Max. Negotiated Rate |
$13,808.00 |
| Rate for Payer: Adventist Health Commercial |
$1,287.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,145.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,587.88
|
| Rate for Payer: Blue Shield of California EPN |
$2,587.88
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,961.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,476.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,980.56
|
| Rate for Payer: Heritage Provider Network Senior |
$2,980.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,609.38
|
| Rate for Payer: Multiplan Commercial |
$4,828.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,325.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,131.46
|
|
|
HC STENT COVERED I CAST
|
Facility
|
OP
|
$6,437.50
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909020087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,287.50 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$1,287.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,978.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,471.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,540.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,828.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,587.88
|
| Rate for Payer: Blue Shield of California EPN |
$2,587.88
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,961.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,471.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,471.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,471.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,120.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,980.56
|
| Rate for Payer: Heritage Provider Network Senior |
$2,980.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,609.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,506.25
|
| Rate for Payer: Multiplan Commercial |
$4,828.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,325.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,131.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,471.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,471.88
|
| Rate for Payer: Vantage Medical Group Senior |
$5,471.88
|
|
|
HC STENT DUMONT TRACHEOBRONCHIAL
|
Facility
|
OP
|
$1,717.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
900803701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.40 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Adventist Health Commercial |
$343.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,061.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,459.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$944.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,287.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,770.00
|
| Rate for Payer: Blue Shield of California Commercial |
$690.23
|
| Rate for Payer: Blue Shield of California EPN |
$690.23
|
| Rate for Payer: Cash Price |
$772.65
|
| Rate for Payer: Cash Price |
$772.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$789.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,459.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,459.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,459.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,098.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$794.97
|
| Rate for Payer: Heritage Provider Network Senior |
$794.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$858.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$858.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$858.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,201.90
|
| Rate for Payer: Multiplan Commercial |
$1,287.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$620.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$568.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,459.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,459.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,459.45
|
|
