|
HC VANCOMYCIN
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
900910934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Adventist Health Commercial |
$49.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$168.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.66
|
| Rate for Payer: Blue Shield of California Commercial |
$109.04
|
| Rate for Payer: Blue Shield of California EPN |
$87.46
|
| Rate for Payer: Cash Price |
$134.75
|
| Rate for Payer: Cash Price |
$134.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$159.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.89
|
| Rate for Payer: Dignity Health Senior |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$151.66
|
| Rate for Payer: Heritage Provider Network Senior |
$151.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.06
|
| Rate for Payer: Multiplan Commercial |
$183.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.54
|
| Rate for Payer: TriValley Medical Group Senior |
$13.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Vantage Medical Group Senior |
$13.54
|
|
|
HC VANCOMYCIN
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
900910934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.34 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Adventist Health Commercial |
$49.00
|
| Rate for Payer: Cash Price |
$134.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$165.87
|
| Rate for Payer: Heritage Provider Network Senior |
$165.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.25
|
| Rate for Payer: Multiplan Commercial |
$183.75
|
|
|
HC VANILLYLMANDELIC ACID 24 HR UR
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900914082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$141.55 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.55
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California EPN |
$100.07
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.05
|
| Rate for Payer: Dignity Health Senior |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.24
|
| Rate for Payer: Heritage Provider Network Senior |
$14.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.53
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.50
|
|
|
HC VANILLYLMANDELIC ACID 24 HR UR
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900914082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.57
|
| Rate for Payer: Heritage Provider Network Senior |
$15.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
|
|
HC VANILLYLMANDELIC ACID URINE 24 HOURS
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900912225
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
|
|
HC VANILLYLMANDELIC ACID URINE 24 HOURS
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900912225
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$141.55 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.55
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California EPN |
$100.07
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.05
|
| Rate for Payer: Dignity Health Senior |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.53
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.50
|
|
|
HC VANILLYLMANDELIC ACID URINE RANDOM
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900912224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
|
|
HC VANILLYLMANDELIC ACID URINE RANDOM
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900912224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$141.55 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.55
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California EPN |
$100.07
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.05
|
| Rate for Payer: Dignity Health Senior |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.53
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.50
|
|
|
HC VANILMANDELIC ACID
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900910531
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
|
|
HC VANILMANDELIC ACID
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
900910531
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$141.55 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.55
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California EPN |
$100.07
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.05
|
| Rate for Payer: Dignity Health Senior |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.53
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.50
|
|
|
HC VAN SONNENBERG SUMP (COOK)
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001067
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$90.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$217.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$182.51
|
| Rate for Payer: Blue Shield of California EPN |
$182.51
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$208.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$210.20
|
| Rate for Payer: Heritage Provider Network Senior |
$210.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$227.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$227.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.50
|
| Rate for Payer: Multiplan Commercial |
$340.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$150.32
|
|
|
HC VAN SONNENBERG SUMP (COOK)
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001067
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$90.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$217.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$311.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$249.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$340.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$182.51
|
| Rate for Payer: Blue Shield of California EPN |
$182.51
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$208.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$385.90
|
| Rate for Payer: Dignity Health Senior |
$385.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$210.20
|
| Rate for Payer: Heritage Provider Network Senior |
$210.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$227.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$227.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$317.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$317.80
|
| Rate for Payer: Multiplan Commercial |
$340.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$150.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$385.90
|
| Rate for Payer: Vantage Medical Group Senior |
$385.90
|
|
|
HC VARICELLA ZOSTER ANTIBODY
|
Facility
|
OP
|
$144.73
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900913671
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$117.64 |
| Rate for Payer: Adventist Health Commercial |
$28.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$77.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$99.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.64
|
| Rate for Payer: Blue Shield of California Commercial |
$103.68
|
| Rate for Payer: Blue Shield of California EPN |
$83.16
|
| Rate for Payer: Cash Price |
$79.60
|
| Rate for Payer: Cash Price |
$79.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$94.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.07
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$89.59
|
| Rate for Payer: Heritage Provider Network Senior |
$89.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$69.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$108.55
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC VARICELLA ZOSTER ANTIBODY
|
Facility
|
IP
|
$144.73
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900913671
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$108.55 |
| Rate for Payer: Adventist Health Commercial |
$28.95
|
| Rate for Payer: Cash Price |
$79.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$97.98
|
| Rate for Payer: Heritage Provider Network Senior |
$97.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.18
|
| Rate for Payer: Multiplan Commercial |
$108.55
|
|
|
HC VASC EMBOLIZATION, VENOUS, TUMORS, ORG ISCHEM, INFARC
|
Facility
|
OP
|
$38,543.00
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
906820013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$28,907.25 |
| Rate for Payer: Adventist Health Commercial |
$7,708.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,479.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$21,198.65
|
| Rate for Payer: Cash Price |
$21,198.65
|
| Rate for Payer: Cash Price |
$21,198.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25,052.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,858.12
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$826.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,976.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,635.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$28,907.25
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC VASC EMBOLIZATION, VENOUS, TUMORS, ORG ISCHEM, INFARC
|
Facility
|
OP
|
$44,324.00
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
900100013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$33,243.00 |
| Rate for Payer: Adventist Health Commercial |
$8,864.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,450.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$24,378.20
|
| Rate for Payer: Cash Price |
$24,378.20
|
| Rate for Payer: Cash Price |
$24,378.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28,810.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$27,436.56
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$826.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,022.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,081.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$33,243.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC VASC EMBOLIZATION, VENOUS, TUMORS, ORG ISCHEM, INFARC
|
Facility
|
IP
|
$44,324.00
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
900100013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,022.64 |
| Max. Negotiated Rate |
$33,243.00 |
| Rate for Payer: Adventist Health Commercial |
$8,864.80
|
| Rate for Payer: Cash Price |
$24,378.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,007.35
|
| Rate for Payer: Heritage Provider Network Senior |
$30,007.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,022.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,081.00
|
| Rate for Payer: Multiplan Commercial |
$33,243.00
|
|
|
HC VASC EMBOLIZATION, VENOUS, TUMORS, ORG ISCHEM, INFARC
|
Facility
|
IP
|
$38,543.00
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
906820013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,976.28 |
| Max. Negotiated Rate |
$28,907.25 |
| Rate for Payer: Adventist Health Commercial |
$7,708.60
|
| Rate for Payer: Cash Price |
$21,198.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$26,093.61
|
| Rate for Payer: Heritage Provider Network Senior |
$26,093.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,976.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,635.75
|
| Rate for Payer: Multiplan Commercial |
$28,907.25
|
|
|
HC VASC EMBOL OCC ARTERIAL
|
Facility
|
IP
|
$50,530.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
906820007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,145.93 |
| Max. Negotiated Rate |
$37,897.50 |
| Rate for Payer: Adventist Health Commercial |
$10,106.00
|
| Rate for Payer: Cash Price |
$27,791.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$34,208.81
|
| Rate for Payer: Heritage Provider Network Senior |
$34,208.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,145.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,632.50
|
| Rate for Payer: Multiplan Commercial |
$37,897.50
|
|
|
HC VASC EMBOL OCC ARTERIAL
|
Facility
|
OP
|
$45,081.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
906811476
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$9,016.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,970.65
|
| 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 |
$8,785.00
|
| 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 |
$24,794.55
|
| Rate for Payer: Cash Price |
$24,794.55
|
| Rate for Payer: Cash Price |
$24,794.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29,302.65
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$27,905.14
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$693.60
|
| 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 |
$8,159.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,270.25
|
| 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 |
$33,810.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 VASC EMBOL OCC ARTERIAL
|
Facility
|
OP
|
$50,530.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
906820007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$10,106.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,714.11
|
| 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 |
$8,785.00
|
| 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 |
$27,791.50
|
| Rate for Payer: Cash Price |
$27,791.50
|
| Rate for Payer: Cash Price |
$27,791.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,844.50
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$31,278.07
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$693.60
|
| 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 |
$9,145.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,632.50
|
| 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 |
$37,897.50
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,097.39
|
| Rate for Payer: TriValley Medical Group Senior |
$25,097.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 VASC EMBOL OCC ARTERIAL
|
Facility
|
IP
|
$45,081.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
906811476
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,159.66 |
| Max. Negotiated Rate |
$33,810.75 |
| Rate for Payer: Adventist Health Commercial |
$9,016.20
|
| Rate for Payer: Cash Price |
$24,794.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,519.84
|
| Rate for Payer: Heritage Provider Network Senior |
$30,519.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,159.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,270.25
|
| Rate for Payer: Multiplan Commercial |
$33,810.75
|
|
|
HC VASC EMBOL OCC ART VEN HEM LYM EXTRVST
|
Facility
|
IP
|
$48,566.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
906820008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,790.45 |
| Max. Negotiated Rate |
$36,424.50 |
| Rate for Payer: Adventist Health Commercial |
$9,713.20
|
| Rate for Payer: Cash Price |
$26,711.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$32,879.18
|
| Rate for Payer: Heritage Provider Network Senior |
$32,879.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,790.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,141.50
|
| Rate for Payer: Multiplan Commercial |
$36,424.50
|
|
|
HC VASC EMBOL OCC ART VEN HEM LYM EXTRVST
|
Facility
|
IP
|
$55,851.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
906811477
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,109.03 |
| Max. Negotiated Rate |
$41,888.25 |
| Rate for Payer: Adventist Health Commercial |
$11,170.20
|
| Rate for Payer: Cash Price |
$30,718.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,811.13
|
| Rate for Payer: Heritage Provider Network Senior |
$37,811.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,109.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,962.75
|
| Rate for Payer: Multiplan Commercial |
$41,888.25
|
|
|
HC VASC EMBOL OCC ART VEN HEM LYM EXTRVST
|
Facility
|
OP
|
$48,566.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
906820008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$36,424.50 |
| Rate for Payer: Adventist Health Commercial |
$9,713.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,364.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,785.00
|
| 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 |
$26,711.30
|
| Rate for Payer: Cash Price |
$26,711.30
|
| Rate for Payer: Cash Price |
$26,711.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31,567.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Senior |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,409.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,062.35
|
| Rate for Payer: Heritage Provider Network Senior |
$17,723.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$964.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,377.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,790.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,141.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,155.76
|
| Rate for Payer: Multiplan Commercial |
$36,424.50
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,850.26
|
| Rate for Payer: TriValley Medical Group Senior |
$15,850.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
