|
HC VASC EMBOL OCC ART VEN HEM LYM EXTRVST
|
Facility
|
OP
|
$55,851.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
906811477
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$41,888.25 |
| Rate for Payer: Adventist Health Commercial |
$11,170.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$38,369.64
|
| 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 |
$30,718.05
|
| Rate for Payer: Cash Price |
$30,718.05
|
| Rate for Payer: Cash Price |
$30,718.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$36,303.15
|
| 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 |
$34,571.77
|
| 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 |
$10,109.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,570.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,962.75
|
| 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 |
$41,888.25
|
| 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 EMBOL OCC PX W PRESSURE GEN CATH
|
Facility
|
OP
|
$48,085.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
906811600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$43,350.04 |
| Rate for Payer: Adventist Health Commercial |
$9,617.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33,034.39
|
| 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: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$26,446.75
|
| Rate for Payer: Cash Price |
$26,446.75
|
| Rate for Payer: Cash Price |
$26,446.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$31,255.25
|
| 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 |
$28,851.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,815.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,764.62
|
| Rate for Payer: Heritage Provider Network Senior |
$28,063.45
|
| 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 |
$8,703.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,238.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,021.25
|
| 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 |
$36,063.75
|
| 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 |
$24,042.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$24,042.50
|
| 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 PX W PRESSURE GEN CATH
|
Facility
|
IP
|
$48,085.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
906811600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,703.39 |
| Max. Negotiated Rate |
$36,063.75 |
| Rate for Payer: Adventist Health Commercial |
$9,617.00
|
| Rate for Payer: Cash Price |
$26,446.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$32,553.54
|
| Rate for Payer: Heritage Provider Network Senior |
$32,553.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,703.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,021.25
|
| Rate for Payer: Multiplan Commercial |
$36,063.75
|
|
|
HC VASC EMBOL OCC VENOUS
|
Facility
|
OP
|
$38,543.00
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
906820006
|
|
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 |
$7,098.19
|
| 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 EMBOL OCC VENOUS
|
Facility
|
OP
|
$44,324.00
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
906811475
|
|
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 |
$7,098.19
|
| 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 EMBOL OCC VENOUS
|
Facility
|
IP
|
$44,324.00
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
906811475
|
|
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 EMBOL OCC VENOUS
|
Facility
|
IP
|
$38,543.00
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
906820006
|
|
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 VASOPNEUMATIC DEVICE MCAL
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
901300043
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC VASOPNEUMATIC DEVICE MCAL
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
901300043
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC VASOPNEUMATIC DEVICE MCARE COMM
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900407041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC VASOPNEUMATIC DEVICE MCARE COMM
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900407041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC VASOPNEUMATIC DEVICE OT
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
901307016
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC VASOPNEUMATIC DEVICE OT
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
901307016
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900419065
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
905103107
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$32.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$51.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: Dignity Health Senior |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900419065
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
905103107
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Cash Price |
$43.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$221.38
|
| Rate for Payer: Heritage Provider Network Senior |
$221.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$174.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$224.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$212.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Senior |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$221.38
|
| Rate for Payer: Heritage Provider Network Senior |
$221.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$155.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$228.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$117.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$108.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$42.22 |
| Max. Negotiated Rate |
$12,620.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$224.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$212.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Senior |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$202.41
|
| Rate for Payer: Heritage Provider Network Senior |
$202.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$155.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$228.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$221.38
|
| Rate for Payer: Heritage Provider Network Senior |
$221.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.75
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.02 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$460.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$591.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$541.43
|
| Rate for Payer: Blue Shield of California Commercial |
$441.55
|
| Rate for Payer: Blue Shield of California EPN |
$355.08
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$559.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Senior |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$559.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$307.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$532.96
|
| Rate for Payer: Heritage Provider Network Senior |
$532.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$410.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$353.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$386.98
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$307.13
|
| Rate for Payer: TriValley Medical Group Senior |
$307.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$141.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$141.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.84 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Adventist Health Commercial |
$172.20
|
| Rate for Payer: Cash Price |
$473.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$582.90
|
| Rate for Payer: Heritage Provider Network Senior |
$582.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.25
|
| Rate for Payer: Multiplan Commercial |
$645.75
|
|
|
HC VENA CAVA FILTER
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,872.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,567.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,567.80
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,794.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,106.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,805.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,805.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,950.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,409.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,291.29
|
|
|
HC VENA CAVA FILTER
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,872.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,679.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,567.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,567.80
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,794.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Senior |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,805.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,805.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,950.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,409.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,291.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
