Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE [4989]

Facility

$2.02

Service Code	NDC 10702-076-06
Hospital Charge Code	1734066
Hospital Revenue Code	259
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.52
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.21
Rate for Payer: Aetna of CA Government/Medicare	$1.21
Rate for Payer: Cash Price	$0.91
Rate for Payer: Health Smart Auto/Commercial	$1.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.21
Rate for Payer: LLUH Dept of Risk Management WC	$1.11
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.52

METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE [4989]

Facility

$2.02

Service Code	NDC 10702-076-06
Hospital Charge Code	1734066
Hospital Revenue Code	259
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.62
Rate for Payer: Cash Price	$0.91
Rate for Payer: Cigna of CA HMO/PPO	$1.62
Rate for Payer: Health Smart Auto/Commercial	$1.21
Rate for Payer: LLUH Dept of Risk Management WC	$1.11
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.52

METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]

Facility

$15.87

Service Code	NDC 50458-588-01
Hospital Charge Code	1731019
Hospital Revenue Code	259
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$11.90
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$9.52
Rate for Payer: Aetna of CA Government/Medicare	$9.52
Rate for Payer: Cash Price	$7.14
Rate for Payer: Health Smart Auto/Commercial	$9.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$9.52
Rate for Payer: LLUH Dept of Risk Management WC	$8.73
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$11.90

METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]

Facility

$15.87

Service Code	NDC 50458-588-01
Hospital Charge Code	1731019
Hospital Revenue Code	259
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$12.70
Rate for Payer: Cash Price	$7.14
Rate for Payer: Cigna of CA HMO/PPO	$12.70
Rate for Payer: Health Smart Auto/Commercial	$9.52
Rate for Payer: LLUH Dept of Risk Management WC	$8.73
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$11.90

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$12.42

Service Code	NDC 68084-829-25
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$9.94
Rate for Payer: Cash Price	$5.59
Rate for Payer: Cigna of CA HMO/PPO	$9.94
Rate for Payer: Health Smart Auto/Commercial	$7.45
Rate for Payer: LLUH Dept of Risk Management WC	$6.83
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.32

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$12.42

Service Code	NDC 68084-829-95
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.45
Rate for Payer: Aetna of CA Government/Medicare	$7.45
Rate for Payer: Cash Price	$5.59
Rate for Payer: Health Smart Auto/Commercial	$7.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.45
Rate for Payer: LLUH Dept of Risk Management WC	$6.83
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.32

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$12.42

Service Code	NDC 68084-829-25
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.45
Rate for Payer: Aetna of CA Government/Medicare	$7.45
Rate for Payer: Cash Price	$5.59
Rate for Payer: Health Smart Auto/Commercial	$7.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.45
Rate for Payer: LLUH Dept of Risk Management WC	$6.83
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.32

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$12.42

Service Code	NDC 68084-829-95
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$9.94
Rate for Payer: Cash Price	$5.59
Rate for Payer: Cigna of CA HMO/PPO	$9.94
Rate for Payer: Health Smart Auto/Commercial	$7.45
Rate for Payer: LLUH Dept of Risk Management WC	$6.83
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.32

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$16.37

Service Code	NDC 50458-586-01
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$12.28
Rate for Payer: Health Smart Auto/Commercial	$9.82
Rate for Payer: Cash Price	$7.37
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$9.82
Rate for Payer: Aetna of CA Government/Medicare	$9.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$9.82
Rate for Payer: LLUH Dept of Risk Management WC	$9.00
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.28

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]

Facility

$16.37

Service Code	NDC 50458-586-01
Hospital Charge Code	1731018
Hospital Revenue Code	259
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$13.10
Rate for Payer: Cash Price	$7.37
Rate for Payer: Cigna of CA HMO/PPO	$13.10
Rate for Payer: Health Smart Auto/Commercial	$9.82
Rate for Payer: LLUH Dept of Risk Management WC	$9.00
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.28

METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE [33198]

Facility

$13.78

Service Code	NDC 0078-0370-05
Hospital Charge Code	1730090
Hospital Revenue Code	259
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$11.02
Rate for Payer: Cash Price	$6.20
Rate for Payer: Cigna of CA HMO/PPO	$11.02
Rate for Payer: Health Smart Auto/Commercial	$8.27
Rate for Payer: LLUH Dept of Risk Management WC	$7.58
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$10.34

METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE [33198]

Facility

$13.78

Service Code	NDC 0078-0370-05
Hospital Charge Code	1730090
Hospital Revenue Code	259
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$10.34
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$8.27
Rate for Payer: Aetna of CA Government/Medicare	$8.27
Rate for Payer: Cash Price	$6.20
Rate for Payer: Health Smart Auto/Commercial	$8.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$8.27
Rate for Payer: LLUH Dept of Risk Management WC	$7.58
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$10.34

METHYLPREDNISOLONE 125 MG INJ. [4081205]

Facility

$11.68

Service Code	CPT J2930
Hospital Charge Code	1720347
Hospital Revenue Code	636
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$8.76
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.01
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$5.47
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$8.39
Rate for Payer: Aetna of CA Government/Medicare	$7.01
Rate for Payer: Aetna of CA Government/Medicare	$5.47
Rate for Payer: Aetna of CA Government/Medicare	$8.39
Rate for Payer: Cash Price	$6.29
Rate for Payer: Cash Price	$5.26
Rate for Payer: Cash Price	$4.10
Rate for Payer: Health Smart Auto/Commercial	$5.47
Rate for Payer: Health Smart Auto/Commercial	$8.39
Rate for Payer: Health Smart Auto/Commercial	$7.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$8.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$5.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.01
Rate for Payer: LLUH Dept of Risk Management WC	$5.02
Rate for Payer: LLUH Dept of Risk Management WC	$7.69
Rate for Payer: LLUH Dept of Risk Management WC	$6.42
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.76
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$10.48

METHYLPREDNISOLONE 125 MG INJ. [4081205]

Facility

$9.12

Service Code	CPT J2930
Hospital Charge Code	1720347
Hospital Revenue Code	636
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$7.30
Rate for Payer: Cash Price	$4.10
Rate for Payer: Cash Price	$5.26
Rate for Payer: Cash Price	$6.29
Rate for Payer: Cigna of CA HMO/PPO	$11.18
Rate for Payer: Cigna of CA HMO/PPO	$9.34
Rate for Payer: Cigna of CA HMO/PPO	$7.30
Rate for Payer: Health Smart Auto/Commercial	$7.01
Rate for Payer: Health Smart Auto/Commercial	$8.39
Rate for Payer: Health Smart Auto/Commercial	$5.47
Rate for Payer: LLUH Dept of Risk Management WC	$5.02
Rate for Payer: LLUH Dept of Risk Management WC	$6.42
Rate for Payer: LLUH Dept of Risk Management WC	$7.69
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$10.48
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.84
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.76

METHYLPREDNISOLONE 16 MG TABLET [4992]

Facility

$2.98

Service Code	CPT J7509
Hospital Charge Code	1710277
Hospital Revenue Code	636
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.24
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.79
Rate for Payer: Aetna of CA Government/Medicare	$1.79
Rate for Payer: Cash Price	$1.34
Rate for Payer: Health Smart Auto/Commercial	$1.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.79
Rate for Payer: LLUH Dept of Risk Management WC	$1.64
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$2.24

METHYLPREDNISOLONE 16 MG TABLET [4992]

Facility

$2.98

Service Code	CPT J7509
Hospital Charge Code	1710277
Hospital Revenue Code	636
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.38
Rate for Payer: Cash Price	$1.34
Rate for Payer: Cigna of CA HMO/PPO	$2.38
Rate for Payer: Health Smart Auto/Commercial	$1.79
Rate for Payer: LLUH Dept of Risk Management WC	$1.64
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$2.24

METHYLPREDNISOLONE 32 MG TABLET [10575]

Facility

$4.96

Service Code	CPT J7509
Hospital Charge Code	1712385
Hospital Revenue Code	636
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$3.97
Rate for Payer: Cash Price	$2.23
Rate for Payer: Cash Price	$2.00
Rate for Payer: Cigna of CA HMO/PPO	$3.97
Rate for Payer: Cigna of CA HMO/PPO	$3.55
Rate for Payer: Health Smart Auto/Commercial	$2.66
Rate for Payer: Health Smart Auto/Commercial	$2.98
Rate for Payer: LLUH Dept of Risk Management WC	$2.73
Rate for Payer: LLUH Dept of Risk Management WC	$2.44
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.72
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.33

METHYLPREDNISOLONE 32 MG TABLET [10575]

Facility

$4.44

Service Code	CPT J7509
Hospital Charge Code	1712385
Hospital Revenue Code	636
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$3.33
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.66
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.98
Rate for Payer: Aetna of CA Government/Medicare	$2.98
Rate for Payer: Aetna of CA Government/Medicare	$2.66
Rate for Payer: Cash Price	$2.00
Rate for Payer: Cash Price	$2.23
Rate for Payer: Health Smart Auto/Commercial	$2.66
Rate for Payer: Health Smart Auto/Commercial	$2.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.66
Rate for Payer: LLUH Dept of Risk Management WC	$2.73
Rate for Payer: LLUH Dept of Risk Management WC	$2.44
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.72
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.33

METHYLPREDNISOLONE 40 MG INJ. [4081204]

Facility

$7.26

Service Code	CPT J2920
Hospital Charge Code	1720346
Hospital Revenue Code	636
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$5.81
Rate for Payer: Cash Price	$3.27
Rate for Payer: Cash Price	$3.29
Rate for Payer: Cigna of CA HMO/PPO	$5.81
Rate for Payer: Cigna of CA HMO/PPO	$5.84
Rate for Payer: Health Smart Auto/Commercial	$4.38
Rate for Payer: Health Smart Auto/Commercial	$4.36
Rate for Payer: LLUH Dept of Risk Management WC	$4.02
Rate for Payer: LLUH Dept of Risk Management WC	$3.99
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.44
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.48

METHYLPREDNISOLONE 40 MG INJ. [4081204]

Facility

$7.30

Service Code	CPT J2920
Hospital Charge Code	1720346
Hospital Revenue Code	636
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$5.48
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.38
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.36
Rate for Payer: Aetna of CA Government/Medicare	$4.38
Rate for Payer: Aetna of CA Government/Medicare	$4.36
Rate for Payer: Cash Price	$3.29
Rate for Payer: Cash Price	$3.27
Rate for Payer: Health Smart Auto/Commercial	$4.38
Rate for Payer: Health Smart Auto/Commercial	$4.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.36
Rate for Payer: LLUH Dept of Risk Management WC	$4.02
Rate for Payer: LLUH Dept of Risk Management WC	$3.99
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.48
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.44

METHYLPREDNISOLONE 4 MG TABLET [4993]

Facility

$2.01

Service Code	CPT J7509
Hospital Charge Code	1710271
Hospital Revenue Code	636
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.51
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.21
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.62
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.23
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.34
Rate for Payer: Aetna of CA Government/Medicare	$0.62
Rate for Payer: Aetna of CA Government/Medicare	$0.23
Rate for Payer: Aetna of CA Government/Medicare	$1.21
Rate for Payer: Aetna of CA Government/Medicare	$1.34
Rate for Payer: Cash Price	$1.00
Rate for Payer: Cash Price	$0.46
Rate for Payer: Cash Price	$0.18
Rate for Payer: Cash Price	$0.90
Rate for Payer: Health Smart Auto/Commercial	$0.62
Rate for Payer: Health Smart Auto/Commercial	$0.23
Rate for Payer: Health Smart Auto/Commercial	$1.21
Rate for Payer: Health Smart Auto/Commercial	$1.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.21
Rate for Payer: LLUH Dept of Risk Management WC	$0.57
Rate for Payer: LLUH Dept of Risk Management WC	$0.21
Rate for Payer: LLUH Dept of Risk Management WC	$1.11
Rate for Payer: LLUH Dept of Risk Management WC	$1.23
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.51
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.29
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.67
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.77

METHYLPREDNISOLONE 4 MG TABLET [4993]

Facility

$1.03

Service Code	CPT J7509
Hospital Charge Code	1710271
Hospital Revenue Code	636
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.82
Rate for Payer: Cash Price	$0.46
Rate for Payer: Cash Price	$1.00
Rate for Payer: Cash Price	$0.90
Rate for Payer: Cash Price	$0.18
Rate for Payer: Cigna of CA HMO/PPO	$1.78
Rate for Payer: Cigna of CA HMO/PPO	$0.31
Rate for Payer: Cigna of CA HMO/PPO	$0.82
Rate for Payer: Cigna of CA HMO/PPO	$1.61
Rate for Payer: Health Smart Auto/Commercial	$0.23
Rate for Payer: Health Smart Auto/Commercial	$1.21
Rate for Payer: Health Smart Auto/Commercial	$1.34
Rate for Payer: Health Smart Auto/Commercial	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.21
Rate for Payer: LLUH Dept of Risk Management WC	$1.11
Rate for Payer: LLUH Dept of Risk Management WC	$0.57
Rate for Payer: LLUH Dept of Risk Management WC	$1.23
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.77
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.29
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.51
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.67

METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]

Facility

$1.37

Service Code	CPT J7509
Hospital Charge Code	1711427
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.10
Rate for Payer: Cash Price	$0.62
Rate for Payer: Cash Price	$0.17
Rate for Payer: Cigna of CA HMO/PPO	$0.30
Rate for Payer: Cigna of CA HMO/PPO	$1.10
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.82
Rate for Payer: LLUH Dept of Risk Management WC	$0.75
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.28
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.03

METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]

Facility

$1.37

Service Code	CPT J7509
Hospital Charge Code	1711427
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.03
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.82
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.22
Rate for Payer: Aetna of CA Government/Medicare	$0.22
Rate for Payer: Aetna of CA Government/Medicare	$0.82
Rate for Payer: Cash Price	$0.62
Rate for Payer: Cash Price	$0.17
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.82
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: LLUH Dept of Risk Management WC	$0.75
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.03
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.28

METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]

Facility

$29.14

Service Code	CPT J2930
Hospital Charge Code	ERX4081203
Hospital Revenue Code	636
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$23.31
Rate for Payer: Cash Price	$13.11
Rate for Payer: Cash Price	$23.91
Rate for Payer: Cigna of CA HMO/PPO	$23.31
Rate for Payer: Cigna of CA HMO/PPO	$42.51
Rate for Payer: Health Smart Auto/Commercial	$31.88
Rate for Payer: Health Smart Auto/Commercial	$17.48
Rate for Payer: LLUH Dept of Risk Management WC	$29.23
Rate for Payer: LLUH Dept of Risk Management WC	$16.03
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$39.86
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$21.86

Know your out-of-pocket cost for care.

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