|
FOLIC ACID ORAL SOLUTION COMPOUND 1 MG/ML [4080276]
|
Facility
|
IP
|
$0.51
|
|
|
Service Code
|
NDC 9994-0802-76
|
| Hospital Charge Code |
1715010
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Cash Price |
$0.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.41
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.38
|
|
|
FOLIC ACID ORAL SOLUTION COMPOUND 1 MG/ML [4080276]
|
Facility
|
OP
|
$0.51
|
|
|
Service Code
|
NDC 9994-0802-76
|
| Hospital Charge Code |
1715010
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.38 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.31
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.31
|
| Rate for Payer: Cash Price |
$0.23
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.38
|
|
|
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION [22185]
|
Facility
|
IP
|
$788.80
|
|
|
Service Code
|
CPT J1451
|
| Hospital Charge Code |
NDG22185
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$433.84 |
| Max. Negotiated Rate |
$631.04 |
| Rate for Payer: Cash Price |
$354.96
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$960.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$631.04
|
| Rate for Payer: Health Smart Auto/Commercial |
$720.00
|
| Rate for Payer: Health Smart Auto/Commercial |
$473.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$433.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$900.00
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$591.60
|
|
|
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION [22185]
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
CPT J1451
|
| Hospital Charge Code |
NDG22185
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$720.00
|
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$473.28
|
| Rate for Payer: Aetna of CA Government/Medicare |
$720.00
|
| Rate for Payer: Aetna of CA Government/Medicare |
$473.28
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$354.96
|
| Rate for Payer: Health Smart Auto/Commercial |
$473.28
|
| Rate for Payer: Health Smart Auto/Commercial |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$473.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$433.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$591.60
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$900.00
|
|
|
FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE [32215]
|
Facility
|
IP
|
$59.66
|
|
|
Service Code
|
CPT J1652
|
| Hospital Charge Code |
1722035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.81 |
| Max. Negotiated Rate |
$47.73 |
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$47.73
|
| Rate for Payer: Health Smart Auto/Commercial |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.81
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$44.74
|
|
|
FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE [32215]
|
Facility
|
OP
|
$59.66
|
|
|
Service Code
|
CPT J1652
|
| Hospital Charge Code |
1722035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.81 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$35.80
|
| Rate for Payer: Aetna of CA Government/Medicare |
$35.80
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Health Smart Auto/Commercial |
$35.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.81
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$44.74
|
|
|
FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE [108028]
|
Facility
|
IP
|
$110.60
|
|
|
Service Code
|
CPT J1652
|
| Hospital Charge Code |
1721167
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.83 |
| Max. Negotiated Rate |
$88.48 |
| Rate for Payer: Cash Price |
$49.77
|
| Rate for Payer: Cash Price |
$48.89
|
| Rate for Payer: Cash Price |
$85.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$88.48
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$86.91
|
| Rate for Payer: Health Smart Auto/Commercial |
$66.36
|
| Rate for Payer: Health Smart Auto/Commercial |
$114.07
|
| Rate for Payer: Health Smart Auto/Commercial |
$65.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.83
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$142.59
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$82.95
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$81.48
|
|
|
FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE [108028]
|
Facility
|
OP
|
$108.64
|
|
|
Service Code
|
CPT J1652
|
| Hospital Charge Code |
1721167
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.75 |
| Max. Negotiated Rate |
$81.48 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$65.18
|
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$114.07
|
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$66.36
|
| Rate for Payer: Aetna of CA Government/Medicare |
$66.36
|
| Rate for Payer: Aetna of CA Government/Medicare |
$65.18
|
| Rate for Payer: Aetna of CA Government/Medicare |
$114.07
|
| Rate for Payer: Cash Price |
$85.55
|
| Rate for Payer: Cash Price |
$49.77
|
| Rate for Payer: Cash Price |
$48.89
|
| Rate for Payer: Health Smart Auto/Commercial |
$114.07
|
| Rate for Payer: Health Smart Auto/Commercial |
$66.36
|
| Rate for Payer: Health Smart Auto/Commercial |
$65.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$66.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$65.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$114.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.83
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$81.48
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$142.59
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$82.95
|
|
|
FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION [88225]
|
Facility
|
IP
|
$11.15
|
|
|
Service Code
|
NDC 49502-605-95
|
| Hospital Charge Code |
NDG88225
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$8.92 |
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Health Smart Auto/Commercial |
$6.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$8.36
|
|
|
FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION [88225]
|
Facility
|
OP
|
$11.15
|
|
|
Service Code
|
NDC 49502-605-30
|
| Hospital Charge Code |
NDG88225
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$8.36 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$6.69
|
| Rate for Payer: Aetna of CA Government/Medicare |
$6.69
|
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Health Smart Auto/Commercial |
$6.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$6.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$8.36
|
|
|
FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION [88225]
|
Facility
|
IP
|
$11.15
|
|
|
Service Code
|
NDC 49502-605-30
|
| Hospital Charge Code |
NDG88225
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$8.92 |
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Health Smart Auto/Commercial |
$6.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$8.36
|
|
|
FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION [88225]
|
Facility
|
OP
|
$11.15
|
|
|
Service Code
|
NDC 49502-605-95
|
| Hospital Charge Code |
NDG88225
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$8.36 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$6.69
|
| Rate for Payer: Aetna of CA Government/Medicare |
$6.69
|
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Health Smart Auto/Commercial |
$6.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$6.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$8.36
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
IP
|
$401.56
|
|
|
Service Code
|
NDC 0006-3061-00
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$220.86 |
| Max. Negotiated Rate |
$321.25 |
| Rate for Payer: Cash Price |
$180.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$321.25
|
| Rate for Payer: Health Smart Auto/Commercial |
$240.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.86
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$301.17
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
NDC 71839-104-01
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$25.20
|
| Rate for Payer: Aetna of CA Government/Medicare |
$25.20
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Health Smart Auto/Commercial |
$25.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.10
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$31.50
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
IP
|
$401.56
|
|
|
Service Code
|
NDC 0006-3061-01
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$220.86 |
| Max. Negotiated Rate |
$321.25 |
| Rate for Payer: Cash Price |
$180.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$321.25
|
| Rate for Payer: Health Smart Auto/Commercial |
$240.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.86
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$301.17
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
OP
|
$401.56
|
|
|
Service Code
|
NDC 0006-3061-01
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$220.86 |
| Max. Negotiated Rate |
$301.17 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$240.94
|
| Rate for Payer: Aetna of CA Government/Medicare |
$240.94
|
| Rate for Payer: Cash Price |
$180.70
|
| Rate for Payer: Health Smart Auto/Commercial |
$240.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$240.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.86
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$301.17
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
NDC 71839-104-01
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$33.60 |
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.60
|
| Rate for Payer: Health Smart Auto/Commercial |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.10
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$31.50
|
|
|
FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION [106783]
|
Facility
|
OP
|
$401.56
|
|
|
Service Code
|
NDC 0006-3061-00
|
| Hospital Charge Code |
1755762
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$220.86 |
| Max. Negotiated Rate |
$301.17 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$240.94
|
| Rate for Payer: Aetna of CA Government/Medicare |
$240.94
|
| Rate for Payer: Cash Price |
$180.70
|
| Rate for Payer: Health Smart Auto/Commercial |
$240.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$240.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.86
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$301.17
|
|
|
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION [10093]
|
Facility
|
OP
|
$2.27
|
|
|
Service Code
|
CPT J1455
|
| Hospital Charge Code |
1754909
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$1.70 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$1.36
|
| Rate for Payer: Aetna of CA Government/Medicare |
$1.36
|
| Rate for Payer: Cash Price |
$1.02
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$1.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.25
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$1.70
|
|
|
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION [10093]
|
Facility
|
IP
|
$2.27
|
|
|
Service Code
|
CPT J1455
|
| Hospital Charge Code |
1754909
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Cash Price |
$1.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.82
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.25
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$1.70
|
|
|
FOSCARNET INTRAVITREAL INJECTION 2400 MCG/0.1 ML [4081568]
|
Facility
|
OP
|
$2.30
|
|
|
Service Code
|
CPT J1455
|
| Hospital Charge Code |
1754909
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$1.72 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$1.38
|
| Rate for Payer: Aetna of CA Government/Medicare |
$1.38
|
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$1.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$1.72
|
|
|
FOSCARNET INTRAVITREAL INJECTION 2400 MCG/0.1 ML [4081568]
|
Facility
|
IP
|
$2.30
|
|
|
Service Code
|
CPT J1455
|
| Hospital Charge Code |
1754909
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$1.84 |
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.84
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$1.72
|
|
|
FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET [14825]
|
Facility
|
IP
|
$96.38
|
|
|
Service Code
|
NDC 70700-268-99
|
| Hospital Charge Code |
ERX14825
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$53.01 |
| Max. Negotiated Rate |
$77.10 |
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$77.10
|
| Rate for Payer: Health Smart Auto/Commercial |
$57.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.01
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$72.28
|
|
|
FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET [14825]
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 0456-4300-01
|
| Hospital Charge Code |
ERX14825
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$60.24 |
| Max. Negotiated Rate |
$87.62 |
| Rate for Payer: Cash Price |
$49.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.62
|
| Rate for Payer: Health Smart Auto/Commercial |
$65.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.24
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$82.14
|
|
|
FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET [14825]
|
Facility
|
OP
|
$83.76
|
|
|
Service Code
|
NDC 67877-749-57
|
| Hospital Charge Code |
ERX14825
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$46.07 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$50.26
|
| Rate for Payer: Aetna of CA Government/Medicare |
$50.26
|
| Rate for Payer: Cash Price |
$37.69
|
| Rate for Payer: Health Smart Auto/Commercial |
$50.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$50.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.07
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$62.82
|
|
