Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

ALBENDAZOLE 200 MG TABLET [8979]

Facility

$36.00

Service Code	NDC 31722-935-02
Hospital Charge Code	1712227
Hospital Revenue Code	259
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$21.60
Rate for Payer: Aetna of CA Government/Medicare	$21.60
Rate for Payer: Cash Price	$16.20
Rate for Payer: Health Smart Auto/Commercial	$21.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$21.60
Rate for Payer: LLUH Dept of Risk Management WC	$19.80
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$27.00

ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]

Facility

$1.39

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$1.11
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cigna of CA HMO/PPO	$0.90
Rate for Payer: Cigna of CA HMO/PPO	$1.11
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04

ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]

Facility

$1.39

Service Code	CPT P9047
Hospital Charge Code	1770007
Hospital Revenue Code	636
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$1.04
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.83
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.67
Rate for Payer: Aetna of CA Government/Medicare	$0.67
Rate for Payer: Aetna of CA Government/Medicare	$0.83
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cash Price	$0.50
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.83
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84

ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]

Facility

$1.12

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.84
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.67
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.83
Rate for Payer: Aetna of CA Government/Medicare	$0.83
Rate for Payer: Aetna of CA Government/Medicare	$0.67
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cash Price	$0.50
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04

ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]

Facility

$1.39

Service Code	CPT P9047
Hospital Charge Code	1770007
Hospital Revenue Code	636
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$1.11
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cigna of CA HMO/PPO	$0.90
Rate for Payer: Cigna of CA HMO/PPO	$1.11
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [8981]

Facility

$1.39

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$1.04
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.83
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.67
Rate for Payer: Aetna of CA Government/Medicare	$0.67
Rate for Payer: Aetna of CA Government/Medicare	$0.83
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cash Price	$0.63
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [8981]

Facility

$1.12

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.90
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cigna of CA HMO/PPO	$1.11
Rate for Payer: Cigna of CA HMO/PPO	$0.90
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION WRAP [40805272]

Facility

$1.12

Service Code	CPT P9047
Hospital Charge Code	1770007
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.84
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.67
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.83
Rate for Payer: Aetna of CA Government/Medicare	$0.83
Rate for Payer: Aetna of CA Government/Medicare	$0.67
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cash Price	$0.63
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.83
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION WRAP [40805272]

Facility

$1.12

Service Code	CPT P9047
Hospital Charge Code	1770007
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.90
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cigna of CA HMO/PPO	$0.90
Rate for Payer: Cigna of CA HMO/PPO	$1.11
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION WRAP [40805272]

Facility

$1.12

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.84
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.67
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.83
Rate for Payer: Aetna of CA Government/Medicare	$0.67
Rate for Payer: Aetna of CA Government/Medicare	$0.83
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cash Price	$0.63
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.83
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84

ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION WRAP [40805272]

Facility

$1.39

Service Code	CPT P9047
Hospital Charge Code	1770003
Hospital Revenue Code	636
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$1.11
Rate for Payer: Cash Price	$0.63
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cigna of CA HMO/PPO	$0.90
Rate for Payer: Cigna of CA HMO/PPO	$1.11
Rate for Payer: Health Smart Auto/Commercial	$0.67
Rate for Payer: Health Smart Auto/Commercial	$0.83
Rate for Payer: LLUH Dept of Risk Management WC	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.04
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.84

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770006
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.17
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Cash Price	$0.10
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770005
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.13
Rate for Payer: Cigna of CA HMO/PPO	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.17
Rate for Payer: LLUH Dept of Risk Management WC	$0.15
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.21

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.79

Service Code	CPT P9041
Hospital Charge Code	1770002
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.63
Rate for Payer: Cash Price	$0.36
Rate for Payer: Cigna of CA HMO/PPO	$0.63
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.59

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.79

Service Code	CPT P9041
Hospital Charge Code	1770002
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.59
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.47
Rate for Payer: Aetna of CA Government/Medicare	$0.47
Rate for Payer: Cash Price	$0.36
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.59

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770006
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % CONTINUOUS INTRAVENOUS SOLUTION [4088982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770005
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.17
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.17
Rate for Payer: Aetna of CA Government/Medicare	$0.17
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Cash Price	$0.13
Rate for Payer: Cash Price	$0.10
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: LLUH Dept of Risk Management WC	$0.15
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.21
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.79

Service Code	CPT P9041
Hospital Charge Code	1770002
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.63
Rate for Payer: Cash Price	$0.36
Rate for Payer: Cigna of CA HMO/PPO	$0.63
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.59

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770005
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.17
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.14
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.14
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.10
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770006
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.19
Rate for Payer: Cigna of CA HMO/PPO	$0.34
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Health Smart Auto/Commercial	$0.26
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.24
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.32
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.43

Service Code	CPT P9041
Hospital Charge Code	1770006
Hospital Revenue Code	636
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.32
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.26
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.26
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.19
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.24
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.32

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.79

Service Code	CPT P9041
Hospital Charge Code	1770002
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.59
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.47
Rate for Payer: Aetna of CA Government/Medicare	$0.47
Rate for Payer: Cash Price	$0.36
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.59

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION [8982]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770005
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Health Smart Auto/Commercial	$0.14
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: LLUH Dept of Risk Management WC	$0.13
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION WRAP [40820934]

Facility

$0.79

Service Code	CPT P9041
Hospital Charge Code	1770002
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.59
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.47
Rate for Payer: Aetna of CA Government/Medicare	$0.47
Rate for Payer: Cash Price	$0.36
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.59

ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION WRAP [40820934]

Facility

$0.22

Service Code	CPT P9041
Hospital Charge Code	1770006
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cash Price	$0.16
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Cigna of CA HMO/PPO	$0.28
Rate for Payer: Health Smart Auto/Commercial	$0.21
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.19
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.26
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

Know your out-of-pocket cost for care.

All Charges