|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
IP
|
$540.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$97.74 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$108.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$347.76
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$365.58
|
| Rate for Payer: Heritage Provider Network Senior |
$365.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Multiplan Commercial |
$405.00
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
OP
|
$540.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$97.74 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Adventist Health Commercial |
$221.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$333.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$297.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$351.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$459.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$459.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$334.26
|
| Rate for Payer: Heritage Provider Network Senior |
$334.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$257.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$378.00
|
| Rate for Payer: Multiplan Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$459.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$459.00
|
| Rate for Payer: Vantage Medical Group Senior |
$459.00
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$657.90 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$478.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$503.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$479.11
|
| Rate for Payer: Heritage Provider Network Senior |
$479.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$369.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$541.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$657.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.90
|
| Rate for Payer: Vantage Medical Group Senior |
$657.90
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$140.09 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$498.46
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$524.00
|
| Rate for Payer: Heritage Provider Network Senior |
$524.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.50
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: Adventist Health Commercial |
$195.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$404.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$404.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$404.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$404.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.64
|
| Rate for Payer: Heritage Provider Network Senior |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$227.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$404.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$404.60
|
| Rate for Payer: Vantage Medical Group Senior |
$404.60
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$306.54
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$306.54
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: Adventist Health Commercial |
$195.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$404.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$404.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$404.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$404.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.64
|
| Rate for Payer: Heritage Provider Network Senior |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$227.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| 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 |
$404.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$404.60
|
| Rate for Payer: Vantage Medical Group Senior |
$404.60
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: Adventist Health Commercial |
$195.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$404.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$404.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$404.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$404.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.64
|
| Rate for Payer: Heritage Provider Network Senior |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$227.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| 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 |
$404.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$404.60
|
| Rate for Payer: Vantage Medical Group Senior |
$404.60
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$306.54
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC TRT SWALLOW ORAL FUNC FEEDING MCARE COMM
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: Adventist Health Commercial |
$195.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$404.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| 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 |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$309.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$404.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$404.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$404.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$294.64
|
| Rate for Payer: Heritage Provider Network Senior |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$227.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| 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 |
$404.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$404.60
|
| Rate for Payer: Vantage Medical Group Senior |
$404.60
|
|
|
HC TRT SWALLOW ORAL FUNC FEEDING MCARE COMM
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$95.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$306.54
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.25
|
| Rate for Payer: Heritage Provider Network Senior |
$322.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
|
|
HC TRT TARS BONE FX;W/MANIPUL, EA
|
Facility
|
IP
|
$1,291.00
|
|
|
Service Code
|
CPT 28455
|
| Hospital Charge Code |
900501247
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.67 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Adventist Health Commercial |
$258.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$831.40
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$874.01
|
| Rate for Payer: Heritage Provider Network Senior |
$874.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$233.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.75
|
| Rate for Payer: Multiplan Commercial |
$968.25
|
|
|
HC TRT TARS BONE FX;W/MANIPUL, EA
|
Facility
|
OP
|
$1,291.00
|
|
|
Service Code
|
CPT 28455
|
| Hospital Charge Code |
900501247
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.67 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$258.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$797.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$613.23
|
| Rate for Payer: Blue Shield of California EPN |
$488.00
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Cash Price |
$580.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$839.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,068.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$874.01
|
| Rate for Payer: Heritage Provider Network Senior |
$874.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$615.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$233.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,378.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$968.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$774.60
|
| Rate for Payer: TriValley Medical Group Senior |
$774.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC TRUE CUT SOFT TISSUE
|
Facility
|
IP
|
$79.00
|
|
| Hospital Charge Code |
909001070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.88
|
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.48
|
| Rate for Payer: Heritage Provider Network Senior |
$53.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
|
|
HC TRUE CUT SOFT TISSUE
|
Facility
|
OP
|
$79.00
|
|
| Hospital Charge Code |
909001070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$67.15 |
| Rate for Payer: Adventist Health Commercial |
$15.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$48.82
|
| 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 |
$39.52
|
| Rate for Payer: Blue Shield of California Commercial |
$48.19
|
| Rate for Payer: Blue Shield of California EPN |
$38.55
|
| Rate for Payer: Cash Price |
$35.55
|
| 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 Medicare Advantage |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.90
|
| Rate for Payer: Heritage Provider Network Senior |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$37.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$55.30
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$39.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$39.50
|
| 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 TRUFILL N-BCA
|
Facility
|
IP
|
$6,235.00
|
|
| Hospital Charge Code |
909081833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,128.54 |
| Max. Negotiated Rate |
$4,676.25 |
| Rate for Payer: Adventist Health Commercial |
$1,247.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,015.34
|
| Rate for Payer: Cash Price |
$2,805.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,221.10
|
| Rate for Payer: Heritage Provider Network Senior |
$4,221.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,128.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,558.75
|
| Rate for Payer: Multiplan Commercial |
$4,676.25
|
|
|
HC TRUFILL N-BCA
|
Facility
|
OP
|
$6,235.00
|
|
| Hospital Charge Code |
909081833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,128.54 |
| Max. Negotiated Rate |
$5,299.75 |
| Rate for Payer: Adventist Health Commercial |
$1,247.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,853.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,299.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,429.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,676.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,118.75
|
| Rate for Payer: Blue Shield of California Commercial |
$3,803.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,042.68
|
| Rate for Payer: Cash Price |
$2,805.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,052.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,299.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,299.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,299.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,678.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,859.47
|
| Rate for Payer: Heritage Provider Network Senior |
$3,859.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,974.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,128.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,558.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,364.50
|
| Rate for Payer: Multiplan Commercial |
$4,676.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,117.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,117.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,299.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,299.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5,299.75
|
|
|
HC TRYPSIN STOOL
|
Facility
|
IP
|
$449.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.27 |
| Max. Negotiated Rate |
$336.75 |
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$289.16
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$303.97
|
| Rate for Payer: Heritage Provider Network Senior |
$303.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.25
|
| Rate for Payer: Multiplan Commercial |
$336.75
|
|
|
HC TRYPSIN STOOL
|
Facility
|
OP
|
$449.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.30 |
| Max. Negotiated Rate |
$336.75 |
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$277.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$58.75
|
| Rate for Payer: Blue Shield of California Commercial |
$58.75
|
| Rate for Payer: Blue Shield of California EPN |
$47.12
|
| Rate for Payer: Blue Shield of California EPN |
$47.12
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$291.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.29
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$277.93
|
| Rate for Payer: Heritage Provider Network Senior |
$19.19
|
| Rate for Payer: Heritage Provider Network Senior |
$277.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$14.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$214.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Multiplan Commercial |
$336.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.30
|
| Rate for Payer: TriValley Medical Group Senior |
$7.30
|
| Rate for Payer: TriValley Medical Group Senior |
$7.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.88
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.88
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Vantage Medical Group Senior |
$7.30
|
| Rate for Payer: Vantage Medical Group Senior |
$7.30
|
|
|
HC TSH (THYROTROPIN)
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$228.75 |
| Rate for Payer: Adventist Health Commercial |
$61.00
|
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$188.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.55
|
| Rate for Payer: Blue Shield of California Commercial |
$135.19
|
| Rate for Payer: Blue Shield of California Commercial |
$135.19
|
| Rate for Payer: Blue Shield of California EPN |
$108.43
|
| Rate for Payer: Blue Shield of California EPN |
$108.43
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$70.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$198.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.31
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.79
|
| Rate for Payer: Heritage Provider Network Senior |
$67.47
|
| Rate for Payer: Heritage Provider Network Senior |
$188.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$51.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$145.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.51
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: Multiplan Commercial |
$228.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Senior |
$16.80
|
| Rate for Payer: TriValley Medical Group Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
|
|
HC TSH (THYROTROPIN)
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$228.75 |
| Rate for Payer: Adventist Health Commercial |
$61.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$196.42
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$206.49
|
| Rate for Payer: Heritage Provider Network Senior |
$206.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.25
|
| Rate for Payer: Multiplan Commercial |
$228.75
|
|
|
HC TTE W OR W/O FOL W/CON,DOPPLER
|
Facility
|
IP
|
$1,309.00
|
|
|
Service Code
|
CPT C8929
|
| Hospital Charge Code |
900200256
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$236.93 |
| Max. Negotiated Rate |
$981.75 |
| Rate for Payer: Adventist Health Commercial |
$261.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$843.00
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$886.19
|
| Rate for Payer: Heritage Provider Network Senior |
$886.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.25
|
| Rate for Payer: Multiplan Commercial |
$981.75
|
|
|
HC TTE W OR W/O FOL W/CON,DOPPLER
|
Facility
|
OP
|
$1,309.00
|
|
|
Service Code
|
CPT C8929
|
| Hospital Charge Code |
900200256
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$236.93 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$261.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$808.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$654.76
|
| Rate for Payer: Blue Shield of California Commercial |
$798.49
|
| Rate for Payer: Blue Shield of California EPN |
$638.79
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$850.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$772.31
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$810.27
|
| Rate for Payer: Heritage Provider Network Senior |
$810.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$624.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$981.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC TTE W WO CONTR ECG
|
Facility
|
OP
|
$1,309.00
|
|
|
Service Code
|
CPT C8930
|
| Hospital Charge Code |
900200257
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$236.93 |
| Max. Negotiated Rate |
$1,512.38 |
| Rate for Payer: Adventist Health Commercial |
$261.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$808.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$654.76
|
| Rate for Payer: Blue Shield of California Commercial |
$798.49
|
| Rate for Payer: Blue Shield of California EPN |
$638.79
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cash Price |
$589.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$850.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$772.31
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,008.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$810.27
|
| Rate for Payer: Heritage Provider Network Senior |
$810.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$624.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$981.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,109.08
|
| Rate for Payer: TriValley Medical Group Senior |
$1,008.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$313.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
