Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

PILOCARPINE 5 MG TABLET [12803]

Facility

$0.49

Service Code	NDC 0527-1313-01
Hospital Charge Code	1711692
Hospital Revenue Code	259
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.37
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.29
Rate for Payer: Aetna of CA Government/Medicare	$0.29
Rate for Payer: Cash Price	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

PILOCARPINE 5 MG TABLET [12803]

Facility

$2.73

Service Code	NDC 68084-928-25
Hospital Charge Code	1711692
Hospital Revenue Code	259
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$2.18
Rate for Payer: Cash Price	$1.23
Rate for Payer: Cigna of CA HMO/PPO	$2.18
Rate for Payer: Health Smart Auto/Commercial	$1.64
Rate for Payer: LLUH Dept of Risk Management WC	$1.50
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$2.05

PILOCARPINE 5 MG TABLET [12803]

Facility

$2.73

Service Code	NDC 68084-928-25
Hospital Charge Code	1711692
Hospital Revenue Code	259
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$2.05
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.64
Rate for Payer: Aetna of CA Government/Medicare	$1.64
Rate for Payer: Cash Price	$1.23
Rate for Payer: Health Smart Auto/Commercial	$1.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.64
Rate for Payer: LLUH Dept of Risk Management WC	$1.50
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$2.05

PILOCARPINE 5 MG TABLET [12803]

Facility

$0.49

Service Code	NDC 0527-1313-01
Hospital Charge Code	1711692
Hospital Revenue Code	259
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.39
Rate for Payer: Cash Price	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.39
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

PILOCARPINE 5 MG TABLET [12803]

Facility

$2.73

Service Code	NDC 68084-928-95
Hospital Charge Code	1711692
Hospital Revenue Code	259
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$2.18
Rate for Payer: Cash Price	$1.23
Rate for Payer: Cigna of CA HMO/PPO	$2.18
Rate for Payer: Health Smart Auto/Commercial	$1.64
Rate for Payer: LLUH Dept of Risk Management WC	$1.50
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$2.05

PIMECROLIMUS 1 % TOPICAL CREAM [32052]

Facility

$11.96

Service Code	NDC 0187-5100-01
Hospital Charge Code	1743701
Hospital Revenue Code	259
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$9.57
Rate for Payer: Cash Price	$5.38
Rate for Payer: Cigna of CA HMO/PPO	$9.57
Rate for Payer: Health Smart Auto/Commercial	$7.18
Rate for Payer: LLUH Dept of Risk Management WC	$6.58
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.97

PIMECROLIMUS 1 % TOPICAL CREAM [32052]

Facility

$11.96

Service Code	NDC 0187-5100-01
Hospital Charge Code	1743701
Hospital Revenue Code	259
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.18
Rate for Payer: Aetna of CA Government/Medicare	$7.18
Rate for Payer: Cash Price	$5.38
Rate for Payer: Health Smart Auto/Commercial	$7.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.18
Rate for Payer: LLUH Dept of Risk Management WC	$6.58
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.97

PIOGLITAZONE 15 MG TABLET [25528]

Facility

$0.44

Service Code	NDC 0781-5420-92
Hospital Charge Code	1710878
Hospital Revenue Code	259
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.35
Rate for Payer: Cash Price	$0.20
Rate for Payer: Cigna of CA HMO/PPO	$0.35
Rate for Payer: Health Smart Auto/Commercial	$0.26
Rate for Payer: LLUH Dept of Risk Management WC	$0.24
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.33

PIOGLITAZONE 15 MG TABLET [25528]

Facility

$0.44

Service Code	NDC 0781-5420-92
Hospital Charge Code	1710878
Hospital Revenue Code	259
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.33
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.26
Rate for Payer: Aetna of CA Government/Medicare	$0.26
Rate for Payer: Cash Price	$0.20
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: LLUH Dept of Risk Management WC	$0.24
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.33

PIOGLITAZONE 30 MG TABLET [25529]

Facility

$0.22

Service Code	NDC 33342-055-07
Hospital Charge Code	1712291
Hospital Revenue Code	259
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

PIOGLITAZONE 30 MG TABLET [25529]

Facility

$0.22

Service Code	NDC 33342-055-07
Hospital Charge Code	1712291
Hospital Revenue Code	259
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

PIPERACILLIN-TAZOBACTAM 2.25 GRAM/50 ML IN DEXTROSE(ISO) IV PIGGYBACK [34523]

Facility

$0.37

Service Code	CPT J2543
Hospital Charge Code	NDG34523
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.30
Rate for Payer: Cash Price	$0.17
Rate for Payer: Cigna of CA HMO/PPO	$0.30
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.28

PIPERACILLIN-TAZOBACTAM 2.25 GRAM/50 ML IN DEXTROSE(ISO) IV PIGGYBACK [34523]

Facility

$0.37

Service Code	CPT J2543
Hospital Charge Code	NDG34523
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.28
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: Cash Price	$0.17
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.28

PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION [18304]

Facility

$6.60

Service Code	CPT J2543
Hospital Charge Code	ERX18304
Hospital Revenue Code	636
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$4.95
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$3.96
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$6.66
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$5.53
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.47
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$5.04
Rate for Payer: Aetna of CA Government/Medicare	$5.53
Rate for Payer: Aetna of CA Government/Medicare	$3.96
Rate for Payer: Aetna of CA Government/Medicare	$2.47
Rate for Payer: Aetna of CA Government/Medicare	$5.04
Rate for Payer: Aetna of CA Government/Medicare	$6.66
Rate for Payer: Cash Price	$3.78
Rate for Payer: Cash Price	$2.97
Rate for Payer: Cash Price	$5.00
Rate for Payer: Cash Price	$4.15
Rate for Payer: Cash Price	$1.85
Rate for Payer: Health Smart Auto/Commercial	$3.96
Rate for Payer: Health Smart Auto/Commercial	$5.04
Rate for Payer: Health Smart Auto/Commercial	$6.66
Rate for Payer: Health Smart Auto/Commercial	$5.53
Rate for Payer: Health Smart Auto/Commercial	$2.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$3.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$6.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$5.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$5.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.47
Rate for Payer: LLUH Dept of Risk Management WC	$3.63
Rate for Payer: LLUH Dept of Risk Management WC	$4.62
Rate for Payer: LLUH Dept of Risk Management WC	$6.10
Rate for Payer: LLUH Dept of Risk Management WC	$5.07
Rate for Payer: LLUH Dept of Risk Management WC	$2.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$4.95
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.92
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.09
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.32
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.30

PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION [18304]

Facility

$8.40

Service Code	CPT J2543
Hospital Charge Code	ERX18304
Hospital Revenue Code	636
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$6.72
Rate for Payer: Cigna of CA HMO/PPO	$6.72
Rate for Payer: Cigna of CA HMO/PPO	$8.88
Rate for Payer: Cigna of CA HMO/PPO	$3.30
Rate for Payer: Cigna of CA HMO/PPO	$7.38
Rate for Payer: Cigna of CA HMO/PPO	$5.28
Rate for Payer: Health Smart Auto/Commercial	$2.47
Rate for Payer: Health Smart Auto/Commercial	$5.04
Rate for Payer: Health Smart Auto/Commercial	$3.96
Rate for Payer: Health Smart Auto/Commercial	$5.53
Rate for Payer: Health Smart Auto/Commercial	$6.66
Rate for Payer: Cash Price	$3.78
Rate for Payer: Cash Price	$1.85
Rate for Payer: Cash Price	$2.97
Rate for Payer: Cash Price	$4.15
Rate for Payer: Cash Price	$5.00
Rate for Payer: LLUH Dept of Risk Management WC	$2.27
Rate for Payer: LLUH Dept of Risk Management WC	$4.62
Rate for Payer: LLUH Dept of Risk Management WC	$3.63
Rate for Payer: LLUH Dept of Risk Management WC	$5.07
Rate for Payer: LLUH Dept of Risk Management WC	$6.10
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$4.95
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.30
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.92
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.32
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.09

PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK [34524]

Facility

$0.49

Service Code	CPT J2543
Hospital Charge Code	1753480
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.39
Rate for Payer: Cash Price	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.39
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK [34524]

Facility

$0.48

Service Code	CPT J2543
Hospital Charge Code	NDG34524
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.38
Rate for Payer: Cash Price	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.38
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.26
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.36

PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK [34524]

Facility

$0.49

Service Code	CPT J2543
Hospital Charge Code	1753480
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.37
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.29
Rate for Payer: Aetna of CA Government/Medicare	$0.29
Rate for Payer: Cash Price	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK [34524]

Facility

$0.48

Service Code	CPT J2543
Hospital Charge Code	NDG34524
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.36
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.29
Rate for Payer: Aetna of CA Government/Medicare	$0.29
Rate for Payer: Cash Price	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.26
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.36

PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION [18303]

Facility

$11.74

Service Code	CPT J2543
Hospital Charge Code	1721150
Hospital Revenue Code	636
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$9.39
Rate for Payer: Cash Price	$5.28
Rate for Payer: Cash Price	$4.75
Rate for Payer: Cigna of CA HMO/PPO	$8.45
Rate for Payer: Cigna of CA HMO/PPO	$9.39
Rate for Payer: Health Smart Auto/Commercial	$7.04
Rate for Payer: Health Smart Auto/Commercial	$6.34
Rate for Payer: LLUH Dept of Risk Management WC	$5.81
Rate for Payer: LLUH Dept of Risk Management WC	$6.46
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.80
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$7.92

PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION [18303]

Facility

$10.56

Service Code	CPT J2543
Hospital Charge Code	1721150
Hospital Revenue Code	636
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$7.92
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$6.34
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.04
Rate for Payer: Aetna of CA Government/Medicare	$6.34
Rate for Payer: Aetna of CA Government/Medicare	$7.04
Rate for Payer: Cash Price	$5.28
Rate for Payer: Cash Price	$4.75
Rate for Payer: Health Smart Auto/Commercial	$7.04
Rate for Payer: Health Smart Auto/Commercial	$6.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$6.34
Rate for Payer: LLUH Dept of Risk Management WC	$5.81
Rate for Payer: LLUH Dept of Risk Management WC	$6.46
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$7.92
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.80

PIPERACILLIN-TAZOBACTAM 4.5 GRAM/100 ML DEXTROSE(ISO-OSM) IV PIGGYBACK [108121]

Facility

$0.31

Service Code	CPT J2543
Hospital Charge Code	NDG108121
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.23
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.19
Rate for Payer: Aetna of CA Government/Medicare	$0.19
Rate for Payer: Cash Price	$0.14
Rate for Payer: Health Smart Auto/Commercial	$0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.19
Rate for Payer: LLUH Dept of Risk Management WC	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.23

PIPERACILLIN-TAZOBACTAM 4.5 GRAM/100 ML DEXTROSE(ISO-OSM) IV PIGGYBACK [108121]

Facility

$0.31

Service Code	CPT J2543
Hospital Charge Code	NDG108121
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.25
Rate for Payer: Health Smart Auto/Commercial	$0.19
Rate for Payer: Cash Price	$0.14
Rate for Payer: Cigna of CA HMO/PPO	$0.25
Rate for Payer: LLUH Dept of Risk Management WC	$0.17
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.23

PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION [18302]

Facility

$16.80

Service Code	CPT J2543
Hospital Charge Code	1721132
Hospital Revenue Code	636
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$13.44
Rate for Payer: Cash Price	$7.56
Rate for Payer: Cash Price	$3.67
Rate for Payer: Cash Price	$5.99
Rate for Payer: Cash Price	$7.53
Rate for Payer: Cash Price	$7.88
Rate for Payer: Cash Price	$3.71
Rate for Payer: Cigna of CA HMO/PPO	$6.53
Rate for Payer: Cigna of CA HMO/PPO	$13.44
Rate for Payer: Cigna of CA HMO/PPO	$14.02
Rate for Payer: Cigna of CA HMO/PPO	$6.59
Rate for Payer: Cigna of CA HMO/PPO	$10.66
Rate for Payer: Cigna of CA HMO/PPO	$13.38
Rate for Payer: Health Smart Auto/Commercial	$4.94
Rate for Payer: Health Smart Auto/Commercial	$10.08
Rate for Payer: Health Smart Auto/Commercial	$10.04
Rate for Payer: Health Smart Auto/Commercial	$4.90
Rate for Payer: Health Smart Auto/Commercial	$10.51
Rate for Payer: Health Smart Auto/Commercial	$7.99
Rate for Payer: LLUH Dept of Risk Management WC	$9.64
Rate for Payer: LLUH Dept of Risk Management WC	$7.33
Rate for Payer: LLUH Dept of Risk Management WC	$4.49
Rate for Payer: LLUH Dept of Risk Management WC	$9.24
Rate for Payer: LLUH Dept of Risk Management WC	$9.20
Rate for Payer: LLUH Dept of Risk Management WC	$4.53
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.18
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.99
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.55
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$13.14
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.12

PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION [18302]

Facility

$16.80

Service Code	CPT J2543
Hospital Charge Code	1721132
Hospital Revenue Code	636
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$10.08
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.90
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$10.04
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$10.51
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.94
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.99
Rate for Payer: Aetna of CA Government/Medicare	$4.90
Rate for Payer: Aetna of CA Government/Medicare	$10.08
Rate for Payer: Aetna of CA Government/Medicare	$7.99
Rate for Payer: Aetna of CA Government/Medicare	$4.94
Rate for Payer: Aetna of CA Government/Medicare	$10.51
Rate for Payer: Aetna of CA Government/Medicare	$10.04
Rate for Payer: Cash Price	$3.67
Rate for Payer: Cash Price	$7.88
Rate for Payer: Cash Price	$7.56
Rate for Payer: Cash Price	$5.99
Rate for Payer: Cash Price	$7.53
Rate for Payer: Cash Price	$3.71
Rate for Payer: Health Smart Auto/Commercial	$10.08
Rate for Payer: Health Smart Auto/Commercial	$4.90
Rate for Payer: Health Smart Auto/Commercial	$10.51
Rate for Payer: Health Smart Auto/Commercial	$4.94
Rate for Payer: Health Smart Auto/Commercial	$7.99
Rate for Payer: Health Smart Auto/Commercial	$10.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$10.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$10.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$10.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.94
Rate for Payer: LLUH Dept of Risk Management WC	$7.33
Rate for Payer: LLUH Dept of Risk Management WC	$9.24
Rate for Payer: LLUH Dept of Risk Management WC	$9.20
Rate for Payer: LLUH Dept of Risk Management WC	$4.53
Rate for Payer: LLUH Dept of Risk Management WC	$9.64
Rate for Payer: LLUH Dept of Risk Management WC	$4.49
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.18
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$9.99
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$6.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$13.14
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$12.55

Know your out-of-pocket cost for care.

All Charges