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Service Code NDC 51672-4215-3
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.56
Max. Negotiated Rate $2.33
Rate for Payer: Adventist Health Commercial $0.62
Rate for Payer: Cash Price $1.71
Rate for Payer: EPIC Health Plan Commercial $1.67
Rate for Payer: Heritage Provider Network Commercial $2.10
Rate for Payer: Heritage Provider Network Senior $2.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.56
Rate for Payer: LLUH Dept of Risk Management WC $0.78
Rate for Payer: Multiplan Commercial $2.33
Service Code NDC 66993-936-61
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.56
Max. Negotiated Rate $2.63
Rate for Payer: Adventist Health Commercial $0.62
Rate for Payer: Aetna of CA Gatekeeper $1.66
Rate for Payer: Aetna of CA Non-Gatekeeper $2.13
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $2.63
Rate for Payer: Alpha Care Medical Group Medi-Cal $1.71
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $2.33
Rate for Payer: Blue Shield of California Commercial $1.89
Rate for Payer: Blue Shield of California EPN $1.51
Rate for Payer: Cash Price $1.71
Rate for Payer: Cigna of CA HMO/PPO $2.02
Rate for Payer: Dignity Health Commercial/Exchange $2.63
Rate for Payer: Dignity Health Medi-Cal $2.63
Rate for Payer: Dignity Health Senior $2.63
Rate for Payer: EPIC Health Plan Commercial $1.98
Rate for Payer: Heritage Provider Network Commercial $1.92
Rate for Payer: Heritage Provider Network Senior $1.92
Rate for Payer: Kaiser Permanente of CA Commercial $1.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.56
Rate for Payer: LLUH Dept of Risk Management WC $0.78
Rate for Payer: Molina Healthcare of CA Medi-Cal $2.17
Rate for Payer: Molina Healthcare of CA Medicare $2.17
Rate for Payer: Multiplan Commercial $2.33
Rate for Payer: TriValley Medical Group Commercial $1.24
Rate for Payer: TriValley Medical Group Senior $1.24
Rate for Payer: United Healthcare All Other HMO/non HMO $1.55
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.55
Rate for Payer: Vantage Medical Group Commercial/Exchange $2.63
Rate for Payer: Vantage Medical Group Medi-Cal $2.63
Rate for Payer: Vantage Medical Group Senior $2.63
Service Code NDC 50111-333-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.31
Rate for Payer: Adventist Health Commercial $0.07
Rate for Payer: Aetna of CA Gatekeeper $0.19
Rate for Payer: Aetna of CA Non-Gatekeeper $0.25
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.31
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.20
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.27
Rate for Payer: Blue Shield of California Commercial $0.22
Rate for Payer: Blue Shield of California EPN $0.18
Rate for Payer: Cash Price $0.20
Rate for Payer: Cigna of CA HMO/PPO $0.23
Rate for Payer: Dignity Health Commercial/Exchange $0.31
Rate for Payer: Dignity Health Medi-Cal $0.31
Rate for Payer: Dignity Health Senior $0.31
Rate for Payer: EPIC Health Plan Commercial $0.23
Rate for Payer: Heritage Provider Network Commercial $0.22
Rate for Payer: Heritage Provider Network Senior $0.22
Rate for Payer: Kaiser Permanente of CA Commercial $0.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.09
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.25
Rate for Payer: Molina Healthcare of CA Medicare $0.25
Rate for Payer: Multiplan Commercial $0.27
Rate for Payer: TriValley Medical Group Commercial $0.14
Rate for Payer: TriValley Medical Group Senior $0.14
Rate for Payer: United Healthcare All Other HMO/non HMO $0.18
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.18
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.31
Rate for Payer: Vantage Medical Group Medi-Cal $0.31
Rate for Payer: Vantage Medical Group Senior $0.31
Service Code NDC 50111-333-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.27
Rate for Payer: Adventist Health Commercial $0.07
Rate for Payer: Cash Price $0.20
Rate for Payer: EPIC Health Plan Commercial $0.19
Rate for Payer: Heritage Provider Network Commercial $0.24
Rate for Payer: Heritage Provider Network Senior $0.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.09
Rate for Payer: Multiplan Commercial $0.27
Service Code NDC 62332-018-50
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $2.14
Max. Negotiated Rate $8.85
Rate for Payer: Adventist Health Commercial $2.36
Rate for Payer: Cash Price $6.49
Rate for Payer: EPIC Health Plan Commercial $6.37
Rate for Payer: Heritage Provider Network Commercial $7.99
Rate for Payer: Heritage Provider Network Senior $7.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.14
Rate for Payer: LLUH Dept of Risk Management WC $2.95
Rate for Payer: Multiplan Commercial $8.85
Service Code NDC 62332-018-50
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $2.14
Max. Negotiated Rate $10.03
Rate for Payer: Adventist Health Commercial $2.36
Rate for Payer: Aetna of CA Gatekeeper $6.31
Rate for Payer: Aetna of CA Non-Gatekeeper $8.11
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $10.03
Rate for Payer: Alpha Care Medical Group Medi-Cal $6.49
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $8.85
Rate for Payer: Blue Shield of California Commercial $7.20
Rate for Payer: Blue Shield of California EPN $5.76
Rate for Payer: Cash Price $6.49
Rate for Payer: Cigna of CA HMO/PPO $7.67
Rate for Payer: Dignity Health Commercial/Exchange $10.03
Rate for Payer: Dignity Health Medi-Cal $10.03
Rate for Payer: Dignity Health Senior $10.03
Rate for Payer: EPIC Health Plan Commercial $7.55
Rate for Payer: Heritage Provider Network Commercial $7.30
Rate for Payer: Heritage Provider Network Senior $7.30
Rate for Payer: Kaiser Permanente of CA Commercial $5.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.14
Rate for Payer: LLUH Dept of Risk Management WC $2.95
Rate for Payer: Molina Healthcare of CA Medi-Cal $8.26
Rate for Payer: Molina Healthcare of CA Medicare $8.26
Rate for Payer: Multiplan Commercial $8.85
Rate for Payer: TriValley Medical Group Commercial $4.72
Rate for Payer: TriValley Medical Group Senior $4.72
Rate for Payer: United Healthcare All Other HMO/non HMO $5.90
Rate for Payer: United Healthcare Navigate/Select/Select+ $5.90
Rate for Payer: Vantage Medical Group Commercial/Exchange $10.03
Rate for Payer: Vantage Medical Group Medi-Cal $10.03
Rate for Payer: Vantage Medical Group Senior $10.03
Service Code HCPCS J1836
Hospital Charge Code 901700025
Hospital Revenue Code 636
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.11
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.02
Rate for Payer: Aetna of CA Gatekeeper $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.03
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.03
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.03
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.02
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.02
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.11
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.02
Rate for Payer: Cigna of CA HMO/PPO $0.01
Rate for Payer: Cigna of CA HMO/PPO $0.02
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: Dignity Health Medi-Cal $0.03
Rate for Payer: Dignity Health Medi-Cal $0.03
Rate for Payer: Dignity Health Senior $0.03
Rate for Payer: Dignity Health Senior $0.03
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Heritage Provider Network Commercial $0.02
Rate for Payer: Heritage Provider Network Commercial $0.01
Rate for Payer: Heritage Provider Network Senior $0.02
Rate for Payer: Heritage Provider Network Senior $0.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.03
Rate for Payer: Kaiser Permanente of CA Commercial $0.02
Rate for Payer: Kaiser Permanente of CA Commercial $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.02
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.03
Rate for Payer: Molina Healthcare of CA Medicare $0.03
Rate for Payer: Molina Healthcare of CA Medicare $0.02
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Senior $0.01
Rate for Payer: TriValley Medical Group Senior $0.02
Rate for Payer: United Healthcare All Other HMO/non HMO $0.01
Rate for Payer: United Healthcare All Other HMO/non HMO $0.01
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.01
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.01
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.03
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code HCPCS J1836
Hospital Charge Code 901700025
Hospital Revenue Code 636
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO/PPO $0.01
Rate for Payer: Cigna of CA HMO/PPO $0.02
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Heritage Provider Network Commercial $0.01
Rate for Payer: Heritage Provider Network Commercial $0.02
Rate for Payer: Heritage Provider Network Senior $0.02
Rate for Payer: Heritage Provider Network Senior $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: United Healthcare All Other HMO/non HMO $0.01
Rate for Payer: United Healthcare All Other HMO/non HMO $0.01
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.01
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.01
Service Code NDC 50111-334-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.49
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA Gatekeeper $0.31
Rate for Payer: Aetna of CA Non-Gatekeeper $0.40
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.49
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.32
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.44
Rate for Payer: Blue Shield of California Commercial $0.35
Rate for Payer: Blue Shield of California EPN $0.28
Rate for Payer: Cash Price $0.32
Rate for Payer: Cigna of CA HMO/PPO $0.38
Rate for Payer: Dignity Health Commercial/Exchange $0.49
Rate for Payer: Dignity Health Medi-Cal $0.49
Rate for Payer: Dignity Health Senior $0.49
Rate for Payer: EPIC Health Plan Commercial $0.37
Rate for Payer: Heritage Provider Network Commercial $0.36
Rate for Payer: Heritage Provider Network Senior $0.36
Rate for Payer: Kaiser Permanente of CA Commercial $0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.41
Rate for Payer: Molina Healthcare of CA Medicare $0.41
Rate for Payer: Multiplan Commercial $0.44
Rate for Payer: TriValley Medical Group Commercial $0.23
Rate for Payer: TriValley Medical Group Senior $0.23
Rate for Payer: United Healthcare All Other HMO/non HMO $0.29
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.29
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.49
Rate for Payer: Vantage Medical Group Medi-Cal $0.49
Rate for Payer: Vantage Medical Group Senior $0.49
Service Code NDC 50111-334-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.46
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Cash Price $0.34
Rate for Payer: EPIC Health Plan Commercial $0.33
Rate for Payer: Heritage Provider Network Commercial $0.41
Rate for Payer: Heritage Provider Network Senior $0.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.46
Service Code NDC 60687-550-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.16
Max. Negotiated Rate $0.68
Rate for Payer: Adventist Health Commercial $0.18
Rate for Payer: Cash Price $0.50
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.61
Rate for Payer: Heritage Provider Network Senior $0.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Multiplan Commercial $0.68
Service Code NDC 50268-535-15
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.57
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Cash Price $0.42
Rate for Payer: EPIC Health Plan Commercial $0.41
Rate for Payer: Heritage Provider Network Commercial $0.51
Rate for Payer: Heritage Provider Network Senior $0.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Multiplan Commercial $0.57
Service Code NDC 68001-365-00
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.46
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Cash Price $0.34
Rate for Payer: EPIC Health Plan Commercial $0.33
Rate for Payer: Heritage Provider Network Commercial $0.41
Rate for Payer: Heritage Provider Network Senior $0.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.46
Service Code NDC 29300-227-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.39
Rate for Payer: Adventist Health Commercial $0.09
Rate for Payer: Aetna of CA Gatekeeper $0.25
Rate for Payer: Aetna of CA Non-Gatekeeper $0.32
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.39
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.25
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.35
Rate for Payer: Blue Shield of California Commercial $0.28
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.25
Rate for Payer: Cigna of CA HMO/PPO $0.30
Rate for Payer: Dignity Health Commercial/Exchange $0.39
Rate for Payer: Dignity Health Medi-Cal $0.39
Rate for Payer: Dignity Health Senior $0.39
Rate for Payer: EPIC Health Plan Commercial $0.29
Rate for Payer: Heritage Provider Network Commercial $0.28
Rate for Payer: Heritage Provider Network Senior $0.28
Rate for Payer: Kaiser Permanente of CA Commercial $0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.32
Rate for Payer: Molina Healthcare of CA Medicare $0.32
Rate for Payer: Multiplan Commercial $0.35
Rate for Payer: TriValley Medical Group Commercial $0.18
Rate for Payer: TriValley Medical Group Senior $0.18
Rate for Payer: United Healthcare All Other HMO/non HMO $0.23
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.23
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.39
Rate for Payer: Vantage Medical Group Medi-Cal $0.39
Rate for Payer: Vantage Medical Group Senior $0.39
Service Code NDC 60687-550-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.16
Max. Negotiated Rate $0.77
Rate for Payer: Adventist Health Commercial $0.18
Rate for Payer: Aetna of CA Gatekeeper $0.48
Rate for Payer: Aetna of CA Non-Gatekeeper $0.62
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.77
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.50
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.68
Rate for Payer: Blue Shield of California Commercial $0.55
Rate for Payer: Blue Shield of California EPN $0.44
Rate for Payer: Cash Price $0.50
Rate for Payer: Cigna of CA HMO/PPO $0.59
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Medi-Cal $0.77
Rate for Payer: Dignity Health Senior $0.77
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: Heritage Provider Network Commercial $0.56
Rate for Payer: Heritage Provider Network Senior $0.56
Rate for Payer: Kaiser Permanente of CA Commercial $0.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.63
Rate for Payer: Molina Healthcare of CA Medicare $0.63
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: TriValley Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Senior $0.36
Rate for Payer: United Healthcare All Other HMO/non HMO $0.45
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.45
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Senior $0.77
Service Code NDC 68001-365-00
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.52
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA Gatekeeper $0.33
Rate for Payer: Aetna of CA Non-Gatekeeper $0.42
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.52
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.34
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.46
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.34
Rate for Payer: Cigna of CA HMO/PPO $0.40
Rate for Payer: Dignity Health Commercial/Exchange $0.52
Rate for Payer: Dignity Health Medi-Cal $0.52
Rate for Payer: Dignity Health Senior $0.52
Rate for Payer: EPIC Health Plan Commercial $0.39
Rate for Payer: Heritage Provider Network Commercial $0.38
Rate for Payer: Heritage Provider Network Senior $0.38
Rate for Payer: Kaiser Permanente of CA Commercial $0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.43
Rate for Payer: Molina Healthcare of CA Medicare $0.43
Rate for Payer: Multiplan Commercial $0.46
Rate for Payer: TriValley Medical Group Commercial $0.24
Rate for Payer: TriValley Medical Group Senior $0.24
Rate for Payer: United Healthcare All Other HMO/non HMO $0.31
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.31
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.52
Rate for Payer: Vantage Medical Group Medi-Cal $0.52
Rate for Payer: Vantage Medical Group Senior $0.52
Service Code NDC 50268-535-15
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Aetna of CA Gatekeeper $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $0.52
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.42
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.57
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.37
Rate for Payer: Cash Price $0.42
Rate for Payer: Cigna of CA HMO/PPO $0.49
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: Dignity Health Medi-Cal $0.65
Rate for Payer: Dignity Health Senior $0.65
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.47
Rate for Payer: Heritage Provider Network Senior $0.47
Rate for Payer: Kaiser Permanente of CA Commercial $0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.53
Rate for Payer: Molina Healthcare of CA Medicare $0.53
Rate for Payer: Multiplan Commercial $0.57
Rate for Payer: TriValley Medical Group Commercial $0.30
Rate for Payer: TriValley Medical Group Senior $0.30
Rate for Payer: United Healthcare All Other HMO/non HMO $0.38
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.38
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.65
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 50111-334-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.52
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA Gatekeeper $0.33
Rate for Payer: Aetna of CA Non-Gatekeeper $0.42
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.52
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.34
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.46
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.34
Rate for Payer: Cigna of CA HMO/PPO $0.40
Rate for Payer: Dignity Health Commercial/Exchange $0.52
Rate for Payer: Dignity Health Medi-Cal $0.52
Rate for Payer: Dignity Health Senior $0.52
Rate for Payer: EPIC Health Plan Commercial $0.39
Rate for Payer: Heritage Provider Network Commercial $0.38
Rate for Payer: Heritage Provider Network Senior $0.38
Rate for Payer: Kaiser Permanente of CA Commercial $0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.43
Rate for Payer: Molina Healthcare of CA Medicare $0.43
Rate for Payer: Multiplan Commercial $0.46
Rate for Payer: TriValley Medical Group Commercial $0.24
Rate for Payer: TriValley Medical Group Senior $0.24
Rate for Payer: United Healthcare All Other HMO/non HMO $0.31
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.31
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.52
Rate for Payer: Vantage Medical Group Medi-Cal $0.52
Rate for Payer: Vantage Medical Group Senior $0.52
Service Code NDC 60687-550-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.16
Max. Negotiated Rate $0.77
Rate for Payer: Adventist Health Commercial $0.18
Rate for Payer: Aetna of CA Gatekeeper $0.48
Rate for Payer: Aetna of CA Non-Gatekeeper $0.62
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.77
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.50
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.68
Rate for Payer: Blue Shield of California Commercial $0.55
Rate for Payer: Blue Shield of California EPN $0.44
Rate for Payer: Cash Price $0.50
Rate for Payer: Cigna of CA HMO/PPO $0.59
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Medi-Cal $0.77
Rate for Payer: Dignity Health Senior $0.77
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: Heritage Provider Network Commercial $0.56
Rate for Payer: Heritage Provider Network Senior $0.56
Rate for Payer: Kaiser Permanente of CA Commercial $0.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.63
Rate for Payer: Molina Healthcare of CA Medicare $0.63
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: TriValley Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Senior $0.36
Rate for Payer: United Healthcare All Other HMO/non HMO $0.45
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.45
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Senior $0.77
Service Code NDC 60687-550-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.16
Max. Negotiated Rate $0.68
Rate for Payer: Adventist Health Commercial $0.18
Rate for Payer: Cash Price $0.50
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.61
Rate for Payer: Heritage Provider Network Senior $0.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Multiplan Commercial $0.68
Service Code NDC 50268-535-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Aetna of CA Gatekeeper $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $0.52
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.42
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.57
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.37
Rate for Payer: Cash Price $0.42
Rate for Payer: Cigna of CA HMO/PPO $0.49
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: Dignity Health Medi-Cal $0.65
Rate for Payer: Dignity Health Senior $0.65
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.47
Rate for Payer: Heritage Provider Network Senior $0.47
Rate for Payer: Kaiser Permanente of CA Commercial $0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.53
Rate for Payer: Molina Healthcare of CA Medicare $0.53
Rate for Payer: Multiplan Commercial $0.57
Rate for Payer: TriValley Medical Group Commercial $0.30
Rate for Payer: TriValley Medical Group Senior $0.30
Rate for Payer: United Healthcare All Other HMO/non HMO $0.38
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.38
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.65
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 16571-664-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.19
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Aetna of CA Gatekeeper $0.12
Rate for Payer: Aetna of CA Non-Gatekeeper $0.15
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.19
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.12
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.17
Rate for Payer: Blue Shield of California Commercial $0.13
Rate for Payer: Blue Shield of California EPN $0.11
Rate for Payer: Cash Price $0.12
Rate for Payer: Cigna of CA HMO/PPO $0.14
Rate for Payer: Dignity Health Commercial/Exchange $0.19
Rate for Payer: Dignity Health Medi-Cal $0.19
Rate for Payer: Dignity Health Senior $0.19
Rate for Payer: EPIC Health Plan Commercial $0.14
Rate for Payer: Heritage Provider Network Commercial $0.14
Rate for Payer: Heritage Provider Network Senior $0.14
Rate for Payer: Kaiser Permanente of CA Commercial $0.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.15
Rate for Payer: Molina Healthcare of CA Medicare $0.15
Rate for Payer: Multiplan Commercial $0.17
Rate for Payer: TriValley Medical Group Commercial $0.09
Rate for Payer: TriValley Medical Group Senior $0.09
Rate for Payer: United Healthcare All Other HMO/non HMO $0.11
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.11
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.19
Rate for Payer: Vantage Medical Group Medi-Cal $0.19
Rate for Payer: Vantage Medical Group Senior $0.19
Service Code NDC 50268-535-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.57
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Cash Price $0.42
Rate for Payer: EPIC Health Plan Commercial $0.41
Rate for Payer: Heritage Provider Network Commercial $0.51
Rate for Payer: Heritage Provider Network Senior $0.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Multiplan Commercial $0.57
Service Code NDC 50111-334-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.44
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Cash Price $0.32
Rate for Payer: EPIC Health Plan Commercial $0.31
Rate for Payer: Heritage Provider Network Commercial $0.39
Rate for Payer: Heritage Provider Network Senior $0.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.44
Service Code NDC 29300-227-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.35
Rate for Payer: Adventist Health Commercial $0.09
Rate for Payer: Cash Price $0.25
Rate for Payer: EPIC Health Plan Commercial $0.25
Rate for Payer: Heritage Provider Network Commercial $0.31
Rate for Payer: Heritage Provider Network Senior $0.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.35