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Service Code NDC 2390000015
Hospital Charge Code NDG76967A
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: Cash Price $0.03
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Heritage Provider Network Commercial $0.05
Rate for Payer: Heritage Provider Network Senior $0.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Service Code NDC 2390000361
Hospital Charge Code NDG28132
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.07
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.06
Rate for Payer: Cash Price $0.04
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: Heritage Provider Network Commercial $0.06
Rate for Payer: Heritage Provider Network Senior $0.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.07
Service Code NDC 37000-544-01
Hospital Charge Code NDG28132
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.08
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Gatekeeper $0.05
Rate for Payer: Aetna of CA Non-Gatekeeper $0.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.08
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.05
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Blue Shield of California Commercial $0.06
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of CA HMO/PPO $0.06
Rate for Payer: Dignity Health Commercial/Exchange $0.08
Rate for Payer: Dignity Health Medi-Cal $0.08
Rate for Payer: Dignity Health Senior $0.08
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Heritage Provider Network Commercial $0.06
Rate for Payer: Heritage Provider Network Senior $0.06
Rate for Payer: Kaiser Permanente of CA Commercial $0.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.07
Rate for Payer: Vantage Medical Group Medi-Cal $0.08
Rate for Payer: Vantage Medical Group Senior $0.08
Service Code NDC 37000-544-06
Hospital Charge Code NDG76967A
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.04
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.06
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.05
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.03
Rate for Payer: Cigna of CA HMO/PPO $0.05
Rate for Payer: Dignity Health Commercial/Exchange $0.06
Rate for Payer: Dignity Health Medi-Cal $0.06
Rate for Payer: Dignity Health Senior $0.06
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Heritage Provider Network Commercial $0.04
Rate for Payer: Heritage Provider Network Senior $0.04
Rate for Payer: Kaiser Permanente of CA Commercial $0.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Vantage Medical Group Medi-Cal $0.06
Rate for Payer: Vantage Medical Group Senior $0.06
Service Code NDC 37000-544-01
Hospital Charge Code NDG28132
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.07
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.06
Rate for Payer: Cash Price $0.04
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: Heritage Provider Network Commercial $0.06
Rate for Payer: Heritage Provider Network Senior $0.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.07
Service Code NDC 2390000361
Hospital Charge Code NDG28132
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.08
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Gatekeeper $0.05
Rate for Payer: Aetna of CA Non-Gatekeeper $0.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.08
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.05
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Blue Shield of California Commercial $0.06
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of CA HMO/PPO $0.06
Rate for Payer: Dignity Health Commercial/Exchange $0.08
Rate for Payer: Dignity Health Medi-Cal $0.08
Rate for Payer: Dignity Health Senior $0.08
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Heritage Provider Network Commercial $0.06
Rate for Payer: Heritage Provider Network Senior $0.06
Rate for Payer: Kaiser Permanente of CA Commercial $0.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.07
Rate for Payer: Vantage Medical Group Medi-Cal $0.08
Rate for Payer: Vantage Medical Group Senior $0.08
Service Code NDC 37000-544-06
Hospital Charge Code NDG76967A
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: Cash Price $0.03
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Heritage Provider Network Commercial $0.05
Rate for Payer: Heritage Provider Network Senior $0.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Service Code NDC 2390003920
Hospital Charge Code NDG28132
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.08
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.07
Rate for Payer: Cash Price $0.05
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: Heritage Provider Network Commercial $0.07
Rate for Payer: Heritage Provider Network Senior $0.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.08
Service Code NDC 0316-0229-75
Hospital Charge Code 1743717
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Heritage Provider Network Commercial $0.03
Rate for Payer: Heritage Provider Network Senior $0.03
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: Multiplan Commercial $0.03
Service Code NDC 46122-573-10
Hospital Charge Code 1743717
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $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 Medi-Cal $0.03
Rate for Payer: Dignity Health Senior $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 Senior $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: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 46122-573-10
Hospital Charge Code 1743717
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Heritage Provider Network Commercial $0.02
Rate for Payer: Heritage Provider Network Senior $0.02
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: Multiplan Commercial $0.02
Service Code NDC 0316-0229-75
Hospital Charge Code 1743717
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cigna of CA HMO/PPO $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 Senior $0.03
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Heritage Provider Network Commercial $0.02
Rate for Payer: Heritage Provider Network Senior $0.02
Rate for Payer: Kaiser Permanente of CA Commercial $0.02
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: Multiplan Commercial $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 0024-5150-05
Hospital Charge Code NDG12562
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.10
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Gatekeeper $0.06
Rate for Payer: Aetna of CA Non-Gatekeeper $0.08
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Blue Shield of California Commercial $0.07
Rate for Payer: Blue Shield of California EPN $0.07
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of CA HMO/PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.10
Rate for Payer: Dignity Health Medi-Cal $0.10
Rate for Payer: Dignity Health Senior $0.10
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Heritage Provider Network Commercial $0.07
Rate for Payer: Heritage Provider Network Senior $0.07
Rate for Payer: Kaiser Permanente of CA Commercial $0.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Vantage Medical Group Medi-Cal $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 0024-5150-06
Hospital Charge Code 1743140
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.10
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Gatekeeper $0.06
Rate for Payer: Aetna of CA Non-Gatekeeper $0.08
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Blue Shield of California Commercial $0.07
Rate for Payer: Blue Shield of California EPN $0.07
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of CA HMO/PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.10
Rate for Payer: Dignity Health Medi-Cal $0.10
Rate for Payer: Dignity Health Senior $0.10
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Heritage Provider Network Commercial $0.07
Rate for Payer: Heritage Provider Network Senior $0.07
Rate for Payer: Kaiser Permanente of CA Commercial $0.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Vantage Medical Group Medi-Cal $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 0024-5150-05
Hospital Charge Code NDG12562
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.08
Rate for Payer: Cash Price $0.05
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Heritage Provider Network Commercial $0.08
Rate for Payer: Heritage Provider Network Senior $0.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.09
Service Code NDC 0024-5150-06
Hospital Charge Code 1743140
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.08
Rate for Payer: Cash Price $0.05
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Heritage Provider Network Commercial $0.08
Rate for Payer: Heritage Provider Network Senior $0.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.09
Service Code NDC 50458-140-30
Hospital Charge Code ERX201798
Hospital Revenue Code 259
Min. Negotiated Rate $4.33
Max. Negotiated Rate $20.35
Rate for Payer: Adventist Health Commercial $4.79
Rate for Payer: Aetna of CA Gatekeeper $12.80
Rate for Payer: Aetna of CA Non-Gatekeeper $16.45
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $20.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $13.17
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $17.96
Rate for Payer: Blue Shield of California Commercial $14.87
Rate for Payer: Blue Shield of California EPN $14.05
Rate for Payer: Cash Price $10.77
Rate for Payer: Cigna of CA HMO/PPO $15.56
Rate for Payer: Dignity Health Commercial/Exchange $20.35
Rate for Payer: Dignity Health Medi-Cal $20.35
Rate for Payer: Dignity Health Senior $20.35
Rate for Payer: EPIC Health Plan Commercial $15.32
Rate for Payer: Heritage Provider Network Commercial $14.82
Rate for Payer: Heritage Provider Network Senior $14.82
Rate for Payer: Kaiser Permanente of CA Commercial $11.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal $4.33
Rate for Payer: LLUH Dept of Risk Management WC $5.98
Rate for Payer: Multiplan Commercial $17.96
Rate for Payer: Vantage Medical Group Medi-Cal $20.35
Rate for Payer: Vantage Medical Group Senior $20.35
Service Code NDC 50458-140-30
Hospital Charge Code ERX201798
Hospital Revenue Code 259
Min. Negotiated Rate $4.33
Max. Negotiated Rate $17.96
Rate for Payer: Adventist Health Commercial $4.79
Rate for Payer: Aetna of CA Non-Gatekeeper $16.45
Rate for Payer: Cash Price $10.77
Rate for Payer: EPIC Health Plan Commercial $12.93
Rate for Payer: Heritage Provider Network Commercial $16.21
Rate for Payer: Heritage Provider Network Senior $16.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal $4.33
Rate for Payer: LLUH Dept of Risk Management WC $5.98
Rate for Payer: Multiplan Commercial $17.96
Service Code NDC 49884-661-09
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.69
Max. Negotiated Rate $3.25
Rate for Payer: Adventist Health Commercial $0.76
Rate for Payer: Aetna of CA Gatekeeper $2.04
Rate for Payer: Aetna of CA Non-Gatekeeper $2.62
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.25
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.86
Rate for Payer: Blue Shield of California Commercial $2.37
Rate for Payer: Blue Shield of California EPN $2.24
Rate for Payer: Cash Price $1.72
Rate for Payer: Cigna of CA HMO/PPO $2.48
Rate for Payer: Dignity Health Commercial/Exchange $3.25
Rate for Payer: Dignity Health Medi-Cal $3.25
Rate for Payer: Dignity Health Senior $3.25
Rate for Payer: EPIC Health Plan Commercial $2.44
Rate for Payer: Heritage Provider Network Commercial $2.36
Rate for Payer: Heritage Provider Network Senior $2.36
Rate for Payer: Kaiser Permanente of CA Commercial $1.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.69
Rate for Payer: LLUH Dept of Risk Management WC $0.96
Rate for Payer: Multiplan Commercial $2.86
Rate for Payer: Vantage Medical Group Medi-Cal $3.25
Rate for Payer: Vantage Medical Group Senior $3.25
Service Code NDC 49884-661-09
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.69
Max. Negotiated Rate $2.86
Rate for Payer: Adventist Health Commercial $0.76
Rate for Payer: Aetna of CA Non-Gatekeeper $2.62
Rate for Payer: Cash Price $1.72
Rate for Payer: EPIC Health Plan Commercial $2.06
Rate for Payer: Heritage Provider Network Commercial $2.59
Rate for Payer: Heritage Provider Network Senior $2.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.69
Rate for Payer: LLUH Dept of Risk Management WC $0.96
Rate for Payer: Multiplan Commercial $2.86
Service Code NDC 33342-117-07
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.37
Max. Negotiated Rate $1.73
Rate for Payer: Adventist Health Commercial $0.41
Rate for Payer: Aetna of CA Gatekeeper $1.09
Rate for Payer: Aetna of CA Non-Gatekeeper $1.40
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.12
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.53
Rate for Payer: Blue Shield of California Commercial $1.27
Rate for Payer: Blue Shield of California EPN $1.20
Rate for Payer: Cash Price $0.92
Rate for Payer: Cigna of CA HMO/PPO $1.33
Rate for Payer: Dignity Health Commercial/Exchange $1.73
Rate for Payer: Dignity Health Medi-Cal $1.73
Rate for Payer: Dignity Health Senior $1.73
Rate for Payer: EPIC Health Plan Commercial $1.31
Rate for Payer: Heritage Provider Network Commercial $1.26
Rate for Payer: Heritage Provider Network Senior $1.26
Rate for Payer: Kaiser Permanente of CA Commercial $0.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.51
Rate for Payer: Multiplan Commercial $1.53
Rate for Payer: Vantage Medical Group Medi-Cal $1.73
Rate for Payer: Vantage Medical Group Senior $1.73
Service Code NDC 0378-3232-93
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.37
Max. Negotiated Rate $1.53
Rate for Payer: Adventist Health Commercial $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $1.40
Rate for Payer: Cash Price $0.92
Rate for Payer: EPIC Health Plan Commercial $1.10
Rate for Payer: Heritage Provider Network Commercial $1.38
Rate for Payer: Heritage Provider Network Senior $1.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.51
Rate for Payer: Multiplan Commercial $1.53
Service Code NDC 33342-117-07
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.37
Max. Negotiated Rate $1.53
Rate for Payer: Adventist Health Commercial $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $1.40
Rate for Payer: Cash Price $0.92
Rate for Payer: EPIC Health Plan Commercial $1.10
Rate for Payer: Heritage Provider Network Commercial $1.38
Rate for Payer: Heritage Provider Network Senior $1.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.51
Rate for Payer: Multiplan Commercial $1.53
Service Code NDC 0378-3232-93
Hospital Charge Code 1712295
Hospital Revenue Code 259
Min. Negotiated Rate $0.37
Max. Negotiated Rate $1.73
Rate for Payer: Adventist Health Commercial $0.41
Rate for Payer: Aetna of CA Gatekeeper $1.09
Rate for Payer: Aetna of CA Non-Gatekeeper $1.40
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.12
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.53
Rate for Payer: Blue Shield of California Commercial $1.27
Rate for Payer: Blue Shield of California EPN $1.20
Rate for Payer: Cash Price $0.92
Rate for Payer: Cigna of CA HMO/PPO $1.33
Rate for Payer: Dignity Health Commercial/Exchange $1.73
Rate for Payer: Dignity Health Medi-Cal $1.73
Rate for Payer: Dignity Health Senior $1.73
Rate for Payer: EPIC Health Plan Commercial $1.31
Rate for Payer: Heritage Provider Network Commercial $1.26
Rate for Payer: Heritage Provider Network Senior $1.26
Rate for Payer: Kaiser Permanente of CA Commercial $0.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.51
Rate for Payer: Multiplan Commercial $1.53
Rate for Payer: Vantage Medical Group Medi-Cal $1.73
Rate for Payer: Vantage Medical Group Senior $1.73
Service Code CPT C9460
Hospital Charge Code ERX210327
Hospital Revenue Code 636
Min. Negotiated Rate $193.74
Max. Negotiated Rate $802.79
Rate for Payer: Adventist Health Commercial $214.08
Rate for Payer: Aetna of CA Non-Gatekeeper $735.36
Rate for Payer: Cash Price $481.68
Rate for Payer: Cigna of CA HMO/PPO $492.38
Rate for Payer: EPIC Health Plan Commercial $578.01
Rate for Payer: Heritage Provider Network Commercial $724.65
Rate for Payer: Heritage Provider Network Senior $724.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal $193.74
Rate for Payer: LLUH Dept of Risk Management WC $267.60
Rate for Payer: Multiplan Commercial $802.79
Rate for Payer: United Healthcare All Other HMO/non HMO $390.26
Rate for Payer: United Healthcare Navigate/Select/Select+ $357.62