|
HC XRAY HIP W/PELVIS BI 5/GT VIEWS
|
Facility
|
OP
|
$1,519.00
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
909073523
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$82.68 |
| Max. Negotiated Rate |
$1,139.25 |
| Rate for Payer: Adventist Health Commercial |
$303.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$811.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,043.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$428.52
|
| Rate for Payer: Blue Shield of California Commercial |
$227.66
|
| Rate for Payer: Blue Shield of California EPN |
$183.08
|
| Rate for Payer: Cash Price |
$835.45
|
| Rate for Payer: Cash Price |
$835.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$987.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$940.26
|
| Rate for Payer: Heritage Provider Network Senior |
$940.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$82.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$724.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$274.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,139.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$307.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$307.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC XRAY HIP W/PELVIS UNI 1 VIEW
|
Facility
|
IP
|
$633.00
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
909073501
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.57 |
| Max. Negotiated Rate |
$474.75 |
| Rate for Payer: Adventist Health Commercial |
$126.60
|
| Rate for Payer: Cash Price |
$348.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$428.54
|
| Rate for Payer: Heritage Provider Network Senior |
$428.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.25
|
| Rate for Payer: Multiplan Commercial |
$474.75
|
|
|
HC XRAY HIP W/PELVIS UNI 1 VIEW
|
Facility
|
OP
|
$633.00
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
909073501
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$474.75 |
| Rate for Payer: Adventist Health Commercial |
$126.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$338.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$434.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.69
|
| Rate for Payer: Blue Shield of California Commercial |
$114.58
|
| Rate for Payer: Blue Shield of California EPN |
$92.14
|
| Rate for Payer: Cash Price |
$348.15
|
| Rate for Payer: Cash Price |
$348.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$411.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$391.83
|
| Rate for Payer: Heritage Provider Network Senior |
$391.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$301.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$474.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$97.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$97.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC XRAY HIP W/PELVIS UNI 2-3 VIEW
|
Facility
|
IP
|
$885.00
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
909073502
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.19 |
| Max. Negotiated Rate |
$663.75 |
| Rate for Payer: Adventist Health Commercial |
$177.00
|
| Rate for Payer: Cash Price |
$486.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$599.14
|
| Rate for Payer: Heritage Provider Network Senior |
$599.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.25
|
| Rate for Payer: Multiplan Commercial |
$663.75
|
|
|
HC XRAY HIP W/PELVIS UNI 2-3 VIEW
|
Facility
|
OP
|
$885.00
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
909073502
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.39 |
| Max. Negotiated Rate |
$663.75 |
| Rate for Payer: Adventist Health Commercial |
$177.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$473.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$608.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$317.70
|
| Rate for Payer: Blue Shield of California Commercial |
$169.10
|
| Rate for Payer: Blue Shield of California EPN |
$135.99
|
| Rate for Payer: Cash Price |
$486.75
|
| Rate for Payer: Cash Price |
$486.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$575.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$547.82
|
| Rate for Payer: Heritage Provider Network Senior |
$547.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$60.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$422.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$663.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$97.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$97.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC XRAY HIP W/PELVIS UNI 4 GT VIEWS
|
Facility
|
IP
|
$1,365.00
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
909073503
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$247.06 |
| Max. Negotiated Rate |
$1,023.75 |
| Rate for Payer: Adventist Health Commercial |
$273.00
|
| Rate for Payer: Cash Price |
$750.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$924.11
|
| Rate for Payer: Heritage Provider Network Senior |
$924.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$247.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.25
|
| Rate for Payer: Multiplan Commercial |
$1,023.75
|
|
|
HC XRAY HIP W/PELVIS UNI 4 GT VIEWS
|
Facility
|
OP
|
$1,365.00
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
909073503
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.44 |
| Max. Negotiated Rate |
$1,023.75 |
| Rate for Payer: Adventist Health Commercial |
$273.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$729.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$937.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$393.61
|
| Rate for Payer: Blue Shield of California Commercial |
$209.52
|
| Rate for Payer: Blue Shield of California EPN |
$168.49
|
| Rate for Payer: Cash Price |
$750.75
|
| Rate for Payer: Cash Price |
$750.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$887.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$844.93
|
| Rate for Payer: Heritage Provider Network Senior |
$844.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$75.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$651.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$247.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$1,023.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$161.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$161.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC XRAY SKULL RADIOGRAPH LTD
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
908801144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.81 |
| Max. Negotiated Rate |
$504.75 |
| Rate for Payer: Adventist Health Commercial |
$134.60
|
| Rate for Payer: Cash Price |
$370.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$455.62
|
| Rate for Payer: Heritage Provider Network Senior |
$455.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.25
|
| Rate for Payer: Multiplan Commercial |
$504.75
|
|
|
HC XRAY SKULL RADIOGRAPH LTD
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
908801144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$504.75 |
| Rate for Payer: Adventist Health Commercial |
$134.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$359.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$462.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.39
|
| Rate for Payer: Blue Shield of California Commercial |
$131.04
|
| Rate for Payer: Blue Shield of California EPN |
$105.38
|
| Rate for Payer: Cash Price |
$370.15
|
| Rate for Payer: Cash Price |
$370.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$437.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$416.59
|
| Rate for Payer: Heritage Provider Network Senior |
$416.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$321.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$504.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC XR RIBS UNI & PA CHEST
|
Facility
|
IP
|
$371.00
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
950463101
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$278.25 |
| Rate for Payer: Adventist Health Commercial |
$74.20
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$251.17
|
| Rate for Payer: Heritage Provider Network Senior |
$251.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.75
|
| Rate for Payer: Multiplan Commercial |
$278.25
|
|
|
HC XR RIBS UNI & PA CHEST
|
Facility
|
OP
|
$371.00
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
950463101
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$52.36 |
| Max. Negotiated Rate |
$278.25 |
| Rate for Payer: Adventist Health Commercial |
$74.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$198.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$254.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.85
|
| Rate for Payer: Blue Shield of California Commercial |
$141.12
|
| Rate for Payer: Blue Shield of California EPN |
$113.48
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$241.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$229.65
|
| Rate for Payer: Heritage Provider Network Senior |
$229.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$52.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$176.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$278.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC XR RIBS W PA CXR
|
Facility
|
IP
|
$371.00
|
|
|
Service Code
|
CPT 71111
|
| Hospital Charge Code |
950463102
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$278.25 |
| Rate for Payer: Adventist Health Commercial |
$74.20
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$251.17
|
| Rate for Payer: Heritage Provider Network Senior |
$251.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.75
|
| Rate for Payer: Multiplan Commercial |
$278.25
|
|
|
HC XR RIBS W PA CXR
|
Facility
|
OP
|
$371.00
|
|
|
Service Code
|
CPT 71111
|
| Hospital Charge Code |
950463102
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$278.25 |
| Rate for Payer: Adventist Health Commercial |
$74.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$198.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$254.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.87
|
| Rate for Payer: Blue Shield of California Commercial |
$188.45
|
| Rate for Payer: Blue Shield of California EPN |
$151.54
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Cash Price |
$204.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$241.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Senior |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$135.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$229.65
|
| Rate for Payer: Heritage Provider Network Senior |
$229.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$68.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$176.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.25
|
| Rate for Payer: Multiplan Commercial |
$278.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$135.12
|
| Rate for Payer: TriValley Medical Group Senior |
$135.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$120.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$120.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC XR TEMP MANDIBULAR BILAT
|
Facility
|
OP
|
$1,044.00
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
909020170
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.71 |
| Max. Negotiated Rate |
$783.00 |
| Rate for Payer: Adventist Health Commercial |
$208.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$558.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$717.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.26
|
| Rate for Payer: Blue Shield of California Commercial |
$178.94
|
| Rate for Payer: Blue Shield of California EPN |
$143.90
|
| Rate for Payer: Cash Price |
$574.20
|
| Rate for Payer: Cash Price |
$574.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$678.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Senior |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$678.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$111.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$646.24
|
| Rate for Payer: Heritage Provider Network Senior |
$646.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$61.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$497.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.97
|
| Rate for Payer: Multiplan Commercial |
$783.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$111.88
|
| Rate for Payer: TriValley Medical Group Senior |
$111.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$71.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$71.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC XR TEMP MANDIBULAR BILAT
|
Facility
|
IP
|
$1,044.00
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
909020170
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$188.96 |
| Max. Negotiated Rate |
$783.00 |
| Rate for Payer: Adventist Health Commercial |
$208.80
|
| Rate for Payer: Cash Price |
$574.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$706.79
|
| Rate for Payer: Heritage Provider Network Senior |
$706.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.00
|
| Rate for Payer: Multiplan Commercial |
$783.00
|
|
|
HC XYLOSE TOLERANCE BLD
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 84620
|
| Hospital Charge Code |
900910321
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$125.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.11
|
| Rate for Payer: Blue Shield of California Commercial |
$95.33
|
| Rate for Payer: Blue Shield of California EPN |
$76.46
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.20
|
| Rate for Payer: Dignity Health Senior |
$12.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$145.47
|
| Rate for Payer: Heritage Provider Network Senior |
$145.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$112.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.27
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.91
|
| Rate for Payer: TriValley Medical Group Senior |
$12.91
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.20
|
| Rate for Payer: Vantage Medical Group Senior |
$12.91
|
|
|
HC XYLOSE TOLERANCE BLD
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
CPT 84620
|
| Hospital Charge Code |
900910321
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.53 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.09
|
| Rate for Payer: Heritage Provider Network Senior |
$159.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
|
|
HC Y90 MICROSPHERES
|
Facility
|
IP
|
$25,200.00
|
|
|
Service Code
|
CPT C2616
|
| Hospital Charge Code |
909301347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,040.00 |
| Max. Negotiated Rate |
$18,900.00 |
| Rate for Payer: Adventist Health Commercial |
$5,040.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,096.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,130.40
|
| Rate for Payer: Blue Shield of California EPN |
$10,130.40
|
| Rate for Payer: Cash Price |
$13,860.00
|
| Rate for Payer: Cash Price |
$13,860.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11,592.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,608.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,667.60
|
| Rate for Payer: Heritage Provider Network Senior |
$11,667.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,600.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,600.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,600.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,300.00
|
| Rate for Payer: Multiplan Commercial |
$18,900.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,104.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,343.72
|
|
|
HC Y90 MICROSPHERES
|
Facility
|
OP
|
$25,200.00
|
|
|
Service Code
|
CPT C2616
|
| Hospital Charge Code |
909301347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,040.00 |
| Max. Negotiated Rate |
$33,324.86 |
| Rate for Payer: Adventist Health Commercial |
$5,040.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,096.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,312.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33,324.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,438.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,216.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,130.40
|
| Rate for Payer: Blue Shield of California EPN |
$10,130.40
|
| Rate for Payer: Cash Price |
$13,860.00
|
| Rate for Payer: Cash Price |
$13,860.00
|
| Rate for Payer: Cash Price |
$13,860.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11,592.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33,324.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,438.23
|
| Rate for Payer: Dignity Health Senior |
$22,216.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,128.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22,216.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,667.60
|
| Rate for Payer: Heritage Provider Network Senior |
$11,667.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,216.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,600.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,600.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,600.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,300.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,992.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,992.88
|
| Rate for Payer: Multiplan Commercial |
$18,900.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$24,438.23
|
| Rate for Payer: TriValley Medical Group Senior |
$22,216.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,104.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,343.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33,324.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,438.23
|
| Rate for Payer: Vantage Medical Group Senior |
$22,216.57
|
|
|
HC Y-90 ZEVALIN UP TO 40 MCI
|
Facility
|
IP
|
$107,795.00
|
|
|
Service Code
|
CPT A9543
|
| Hospital Charge Code |
909301343
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$19,510.90 |
| Max. Negotiated Rate |
$80,846.25 |
| Rate for Payer: Adventist Health Commercial |
$21,559.00
|
| Rate for Payer: Cash Price |
$59,287.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,209.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$72,977.21
|
| Rate for Payer: Heritage Provider Network Senior |
$72,977.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,510.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26,948.75
|
| Rate for Payer: Multiplan Commercial |
$80,846.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$38,946.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$35,690.92
|
|
|
HC Y-90 ZEVALIN UP TO 40 MCI
|
Facility
|
OP
|
$107,795.00
|
|
|
Service Code
|
CPT A9543
|
| Hospital Charge Code |
909301343
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$19,510.90 |
| Max. Negotiated Rate |
$108,223.53 |
| Rate for Payer: Adventist Health Commercial |
$21,559.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57,616.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$74,055.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71,030.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62,507.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62,507.00
|
| Rate for Payer: Blue Shield of California Commercial |
$65,754.95
|
| Rate for Payer: Blue Shield of California EPN |
$52,603.96
|
| Rate for Payer: Cash Price |
$59,287.25
|
| Rate for Payer: Cash Price |
$59,287.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$70,066.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71,030.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$62,507.00
|
| Rate for Payer: Dignity Health Senior |
$62,507.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,988.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$56,824.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$66,725.10
|
| Rate for Payer: Heritage Provider Network Senior |
$66,725.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108,223.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,824.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$51,418.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,510.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,348.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26,948.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,598.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,598.93
|
| Rate for Payer: Multiplan Commercial |
$80,846.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$62,507.00
|
| Rate for Payer: TriValley Medical Group Senior |
$56,824.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$38,946.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$35,690.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71,030.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62,507.00
|
| Rate for Payer: Vantage Medical Group Senior |
$62,507.00
|
|
|
HC ZELANTE CATHETER
|
Facility
|
OP
|
$8,798.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909001757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,759.60 |
| Max. Negotiated Rate |
$13,240.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,223.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,044.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,478.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,838.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,598.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,536.80
|
| Rate for Payer: Blue Shield of California EPN |
$3,536.80
|
| Rate for Payer: Cash Price |
$4,838.90
|
| Rate for Payer: Cash Price |
$4,838.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,047.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,478.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,478.30
|
| Rate for Payer: Dignity Health Senior |
$7,478.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,630.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,073.47
|
| Rate for Payer: Heritage Provider Network Senior |
$4,073.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,399.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,399.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,399.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,199.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,158.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,158.60
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,178.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,913.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,478.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,478.30
|
| Rate for Payer: Vantage Medical Group Senior |
$7,478.30
|
|
|
HC ZELANTE CATHETER
|
Facility
|
IP
|
$8,798.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909001757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,759.60 |
| Max. Negotiated Rate |
$13,277.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,223.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,536.80
|
| Rate for Payer: Blue Shield of California EPN |
$3,536.80
|
| Rate for Payer: Cash Price |
$4,838.90
|
| Rate for Payer: Cash Price |
$4,838.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,047.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,750.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,073.47
|
| Rate for Payer: Heritage Provider Network Senior |
$4,073.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,399.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,399.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,399.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,199.50
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,178.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,913.02
|
|
|
HEPARIN 1000 UNIT/ML INJECTION SOLUTION. [408117968]
|
Facility
|
OP
|
$2.88
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Adventist Health Commercial |
$0.58
|
| Rate for Payer: Adventist Health Commercial |
$0.45
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.34
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.23
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.19
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.22
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.54
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.14
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.17
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.84
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.58
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.14
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.32
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.90
|
| Rate for Payer: Dignity Health Senior |
$1.90
|
| Rate for Payer: Dignity Health Senior |
$2.45
|
| Rate for Payer: Dignity Health Senior |
$0.24
|
| Rate for Payer: Dignity Health Senior |
$0.23
|
| Rate for Payer: Dignity Health Senior |
$0.35
|
| Rate for Payer: Dignity Health Senior |
$2.92
|
| Rate for Payer: Dignity Health Senior |
$0.26
|
| Rate for Payer: Dignity Health Senior |
$5.30
|
| Rate for Payer: Dignity Health Senior |
$0.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.19
|
| Rate for Payer: Heritage Provider Network Senior |
$0.13
|
| Rate for Payer: Heritage Provider Network Senior |
$0.19
|
| Rate for Payer: Heritage Provider Network Senior |
$1.33
|
| Rate for Payer: Heritage Provider Network Senior |
$1.59
|
| Rate for Payer: Heritage Provider Network Senior |
$2.89
|
| Rate for Payer: Heritage Provider Network Senior |
$0.13
|
| Rate for Payer: Heritage Provider Network Senior |
$0.14
|
| Rate for Payer: Heritage Provider Network Senior |
$0.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.29
|
| Rate for Payer: Multiplan Commercial |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$0.32
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Multiplan Commercial |
$4.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.17
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.50
|
| Rate for Payer: TriValley Medical Group Senior |
$0.11
|
| Rate for Payer: TriValley Medical Group Senior |
$0.16
|
| Rate for Payer: TriValley Medical Group Senior |
$0.89
|
| Rate for Payer: TriValley Medical Group Senior |
$0.11
|
| Rate for Payer: TriValley Medical Group Senior |
$2.50
|
| Rate for Payer: TriValley Medical Group Senior |
$1.15
|
| Rate for Payer: TriValley Medical Group Senior |
$0.12
|
| Rate for Payer: TriValley Medical Group Senior |
$1.38
|
| Rate for Payer: TriValley Medical Group Senior |
$0.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1.90
|
| Rate for Payer: Vantage Medical Group Senior |
$0.35
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$0.37
|
| Rate for Payer: Vantage Medical Group Senior |
$0.24
|
| Rate for Payer: Vantage Medical Group Senior |
$2.45
|
|
|
HEPARIN 1000 UNIT/ML INJECTION SOLUTION. [408117968]
|
Facility
|
IP
|
$0.41
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.31 |
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.58
|
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Adventist Health Commercial |
$0.45
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.32
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.13
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.58
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.13
|
| Rate for Payer: Heritage Provider Network Senior |
$1.33
|
| Rate for Payer: Heritage Provider Network Senior |
$0.13
|
| Rate for Payer: Heritage Provider Network Senior |
$0.13
|
| Rate for Payer: Heritage Provider Network Senior |
$0.14
|
| Rate for Payer: Heritage Provider Network Senior |
$0.19
|
| Rate for Payer: Heritage Provider Network Senior |
$0.20
|
| Rate for Payer: Heritage Provider Network Senior |
$1.03
|
| Rate for Payer: Heritage Provider Network Senior |
$2.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$0.32
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$4.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.10
|
|
