Loma Linda University Medical Center

All Charges

Charge

Type

Price

MUCOSITIS COCKTAIL COMPOUND [4080306]

Facility IP

$0.02

Service Code	NDC 9408-0306-02
Hospital Charge Code	1719093
Hospital Revenue Code	259
Max. Negotiated Rate	$0.02
Rate for Payer: Adventist Health Commercial	$0.00
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: EPIC Health Plan Commercial	$0.01
Rate for Payer: Heritage Provider Network Commercial	$0.01
Rate for Payer: Heritage Provider Network Senior	$0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.00
Rate for Payer: LLUH Dept of Risk Management WC	$0.01
Rate for Payer: Multiplan Commercial	$0.02

MUCOSITIS COCKTAIL COMPOUND [4080306]

Facility OP

$0.02

Service Code	NDC 9408-0306-01
Hospital Charge Code	1719093
Hospital Revenue Code	259
Max. Negotiated Rate	$0.02
Rate for Payer: Adventist Health Commercial	$0.00
Rate for Payer: Aetna of CA Gatekeeper	$0.01
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.02
Rate for Payer: Blue Shield of California Commercial	$0.01
Rate for Payer: Blue Shield of California EPN	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of CA HMO/PPO	$0.01
Rate for Payer: Dignity Health Commercial/Exchange	$0.02
Rate for Payer: Dignity Health Medi-Cal	$0.02
Rate for Payer: Dignity Health Senior	$0.02
Rate for Payer: EPIC Health Plan Commercial	$0.01
Rate for Payer: Heritage Provider Network Commercial	$0.01
Rate for Payer: Heritage Provider Network Senior	$0.01
Rate for Payer: Kaiser Permanente of CA Commercial	$0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.00
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	$0.02
Rate for Payer: Vantage Medical Group Senior	$0.02

MUCOSITIS COCKTAIL COMPOUND [4080306]

Facility IP

$0.02

Service Code	NDC 9408-0306-01
Hospital Charge Code	1719093
Hospital Revenue Code	259
Max. Negotiated Rate	$0.02
Rate for Payer: Adventist Health Commercial	$0.00
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: EPIC Health Plan Commercial	$0.01
Rate for Payer: Heritage Provider Network Commercial	$0.01
Rate for Payer: Heritage Provider Network Senior	$0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.00
Rate for Payer: LLUH Dept of Risk Management WC	$0.01
Rate for Payer: Multiplan Commercial	$0.02

MUCOSITIS COCKTAIL COMPOUND [4080306]

Facility OP

$0.02

Service Code	NDC 9408-0306-02
Hospital Charge Code	1719093
Hospital Revenue Code	259
Max. Negotiated Rate	$0.02
Rate for Payer: Adventist Health Commercial	$0.00
Rate for Payer: Aetna of CA Gatekeeper	$0.01
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.02
Rate for Payer: Blue Shield of California Commercial	$0.01
Rate for Payer: Blue Shield of California EPN	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of CA HMO/PPO	$0.01
Rate for Payer: Dignity Health Commercial/Exchange	$0.02
Rate for Payer: Dignity Health Medi-Cal	$0.02
Rate for Payer: Dignity Health Senior	$0.02
Rate for Payer: EPIC Health Plan Commercial	$0.01
Rate for Payer: Heritage Provider Network Commercial	$0.01
Rate for Payer: Heritage Provider Network Senior	$0.01
Rate for Payer: Kaiser Permanente of CA Commercial	$0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.00
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	$0.02
Rate for Payer: Vantage Medical Group Senior	$0.02

MUCOSITIS COCKTAIL (PINK LADY) [4080321]

Facility IP

$0.62

Service Code	NDC 9994-0803-21
Hospital Charge Code	ERX4080321
Hospital Revenue Code	259
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.47
Rate for Payer: Adventist Health Commercial	$0.12
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.43
Rate for Payer: Cash Price	$0.28
Rate for Payer: EPIC Health Plan Commercial	$0.33
Rate for Payer: Heritage Provider Network Commercial	$0.42
Rate for Payer: Heritage Provider Network Senior	$0.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.11
Rate for Payer: LLUH Dept of Risk Management WC	$0.16
Rate for Payer: Multiplan Commercial	$0.47

MUCOSITIS COCKTAIL (PINK LADY) [4080321]

Facility OP

$0.05

Service Code	NDC 9994-0803-06
Hospital Charge Code	NDG4080321
Hospital Revenue Code	259
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
Rate for Payer: Adventist Health Commercial	$0.01
Rate for Payer: Aetna of CA Gatekeeper	$0.03
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.04
Rate for Payer: Blue Shield of California Commercial	$0.03
Rate for Payer: Blue Shield of California EPN	$0.03
Rate for Payer: Cash Price	$0.02
Rate for Payer: Cigna of CA HMO/PPO	$0.03
Rate for Payer: Dignity Health Commercial/Exchange	$0.04
Rate for Payer: Dignity Health Medi-Cal	$0.04
Rate for Payer: Dignity Health Senior	$0.04
Rate for Payer: EPIC Health Plan Commercial	$0.03
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 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	$0.04
Rate for Payer: Vantage Medical Group Medi-Cal	$0.04
Rate for Payer: Vantage Medical Group Senior	$0.04

MUCOSITIS COCKTAIL (PINK LADY) [4080321]

Facility OP

$0.62

Service Code	NDC 9994-0803-21
Hospital Charge Code	ERX4080321
Hospital Revenue Code	259
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.53
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	$0.43
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.53
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.34
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.47
Rate for Payer: Blue Shield of California Commercial	$0.39
Rate for Payer: Blue Shield of California EPN	$0.36
Rate for Payer: Cash Price	$0.28
Rate for Payer: Cigna of CA HMO/PPO	$0.40
Rate for Payer: Dignity Health Commercial/Exchange	$0.53
Rate for Payer: Dignity Health Medi-Cal	$0.53
Rate for Payer: Dignity Health Senior	$0.53
Rate for Payer: EPIC Health Plan Commercial	$0.40
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	$0.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.11
Rate for Payer: LLUH Dept of Risk Management WC	$0.16
Rate for Payer: Multiplan Commercial	$0.47
Rate for Payer: Vantage Medical Group Medi-Cal	$0.53
Rate for Payer: Vantage Medical Group Senior	$0.53

MUCOSITIS COCKTAIL (PINK LADY) [4080321]

Facility IP

$0.05

Service Code	NDC 9994-0803-06
Hospital Charge Code	NDG4080321
Hospital Revenue Code	259
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
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	$0.03
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	$0.04

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility IP

$9,565.93

Service Code	APR-DRG 0432
Min. Negotiated Rate	$9,565.93
Max. Negotiated Rate	$9,565.93
Rate for Payer: IEHP Medi-Cal	$9,565.93

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility IP

$7,103.56

Service Code	APR-DRG 0431
Min. Negotiated Rate	$7,103.56
Max. Negotiated Rate	$7,103.56
Rate for Payer: IEHP Medi-Cal	$7,103.56

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility IP

$14,827.92

Service Code	APR-DRG 0433
Min. Negotiated Rate	$14,827.92
Max. Negotiated Rate	$14,827.92
Rate for Payer: IEHP Medi-Cal	$14,827.92

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility IP

$27,035.31

Service Code	APR-DRG 0434
Min. Negotiated Rate	$27,035.31
Max. Negotiated Rate	$27,035.31
Rate for Payer: IEHP Medi-Cal	$27,035.31

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility IP

$12,806.31

Service Code	APR-DRG 9303
Min. Negotiated Rate	$12,806.31
Max. Negotiated Rate	$12,806.31
Rate for Payer: IEHP Medi-Cal	$12,806.31

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility IP

$8,137.25

Service Code	APR-DRG 9302
Min. Negotiated Rate	$8,137.25
Max. Negotiated Rate	$8,137.25
Rate for Payer: IEHP Medi-Cal	$8,137.25

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility IP

$24,657.50

Service Code	APR-DRG 9304
Min. Negotiated Rate	$24,657.50
Max. Negotiated Rate	$24,657.50
Rate for Payer: IEHP Medi-Cal	$24,657.50

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility IP

$6,759.32

Service Code	APR-DRG 9301
Min. Negotiated Rate	$6,759.32
Max. Negotiated Rate	$6,759.32
Rate for Payer: IEHP Medi-Cal	$6,759.32

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility OP

$0.05

Service Code	NDC 4098522368
Hospital Charge Code	1711088
Hospital Revenue Code	259
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
Rate for Payer: Adventist Health Commercial	$0.01
Rate for Payer: Aetna of CA Gatekeeper	$0.03
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.04
Rate for Payer: Blue Shield of California Commercial	$0.03
Rate for Payer: Blue Shield of California EPN	$0.03
Rate for Payer: Cash Price	$0.02
Rate for Payer: Cigna of CA HMO/PPO	$0.03
Rate for Payer: Dignity Health Commercial/Exchange	$0.04
Rate for Payer: Dignity Health Medi-Cal	$0.04
Rate for Payer: Dignity Health Senior	$0.04
Rate for Payer: EPIC Health Plan Commercial	$0.03
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 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	$0.04
Rate for Payer: Vantage Medical Group Medi-Cal	$0.04
Rate for Payer: Vantage Medical Group Senior	$0.04

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility OP

$0.06

Service Code	NDC 904549261
Hospital Charge Code	1711088
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 Gatekeeper	$0.03
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.03
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	$0.04
Rate for Payer: Dignity Health Commercial/Exchange	$0.05
Rate for Payer: Dignity Health Medi-Cal	$0.05
Rate for Payer: Dignity Health Senior	$0.05
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	$0.05
Rate for Payer: Vantage Medical Group Senior	$0.05

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility IP

$0.04

Service Code	NDC 8068116000
Hospital Charge Code	1711088
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

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility IP

$0.06

Service Code	NDC 904549261
Hospital Charge Code	1711088
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	$0.04
Rate for Payer: Cash Price	$0.03
Rate for Payer: EPIC Health Plan Commercial	$0.03
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 Medi-Cal	$0.01
Rate for Payer: LLUH Dept of Risk Management WC	$0.02
Rate for Payer: Multiplan Commercial	$0.05

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility IP

$0.05

Service Code	NDC 4098522368
Hospital Charge Code	1711088
Hospital Revenue Code	259
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
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	$0.03
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	$0.04

MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET [120459]

Facility OP

$0.04

Service Code	NDC 8068116000
Hospital Charge Code	1711088
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

MULTIVITAMIN WITH FOLIC ACID 400 MCG TABLET [196574]

Facility IP

$0.03

Service Code	NDC 8068105000
Hospital Charge Code	ERX196574
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

MULTIVITAMIN WITH FOLIC ACID 400 MCG TABLET [196574]

Facility OP

$0.03

Service Code	NDC 8068105000
Hospital Charge Code	ERX196574
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

MULTIVITAMIN WITH FOLIC ACID 400 MCG TABLET [196574]

Facility OP

$0.04

Service Code	NDC 8068100300
Hospital Charge Code	ERX196574
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

Price Transparency.

All Charges