|
ADRENAL PROCEDURES
|
Facility
IP
|
$11,505.97
|
|
|
Service Code
|
APR-DRG 4011
|
| Min. Negotiated Rate |
$11,505.97 |
| Max. Negotiated Rate |
$11,505.97 |
| Rate for Payer: IEHP Medi-Cal |
$11,505.97
|
|
|
AFLIBERCEPT 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION [152966]
|
Facility
OP
|
$44,400.00
|
|
|
Service Code
|
CPT J0178
|
| Hospital Charge Code |
NDG152966
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$862.28 |
| Max. Negotiated Rate |
$33,300.00 |
| Rate for Payer: Adventist Health Commercial |
$8,880.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,118.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,502.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,077.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$948.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$948.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,976.76
|
| Rate for Payer: Blue Shield of California Commercial |
$943.50
|
| Rate for Payer: Blue Shield of California EPN |
$943.50
|
| Rate for Payer: Cash Price |
$19,980.00
|
| Rate for Payer: Cash Price |
$19,980.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,424.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,293.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$948.51
|
| Rate for Payer: Dignity Health Senior |
$948.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,416.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$862.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,557.20
|
| Rate for Payer: Heritage Provider Network Senior |
$20,557.20
|
| Rate for Payer: Humana Medicare |
$862.28
|
| Rate for Payer: IEHP Medi-Cal |
$1,352.11
|
| Rate for Payer: IEHP Medicare Advantage |
$862.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,638.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,036.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,017.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,100.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,086.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,086.47
|
| Rate for Payer: Multiplan Commercial |
$33,300.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$948.51
|
| Rate for Payer: TriValley Medical Group Senior |
$862.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16,188.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,834.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,293.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$948.51
|
| Rate for Payer: Vantage Medical Group Senior |
$862.28
|
|
|
AFLIBERCEPT 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION [152966]
|
Facility
IP
|
$44,400.00
|
|
|
Service Code
|
CPT J0178
|
| Hospital Charge Code |
NDG152966
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8,036.40 |
| Max. Negotiated Rate |
$33,300.00 |
| Rate for Payer: Adventist Health Commercial |
$8,880.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,502.80
|
| Rate for Payer: Cash Price |
$19,980.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,424.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,976.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,058.80
|
| Rate for Payer: Heritage Provider Network Senior |
$30,058.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,036.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,100.00
|
| Rate for Payer: Multiplan Commercial |
$33,300.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16,188.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,834.04
|
|
|
AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION [35775]
|
Facility
IP
|
$8,685.12
|
|
|
Service Code
|
CPT J0180
|
| Hospital Charge Code |
1755755
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,572.01 |
| Max. Negotiated Rate |
$6,513.84 |
| Rate for Payer: Adventist Health Commercial |
$1,737.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,966.68
|
| Rate for Payer: Cash Price |
$3,908.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,995.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,689.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,879.83
|
| Rate for Payer: Heritage Provider Network Senior |
$5,879.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,572.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,171.28
|
| Rate for Payer: Multiplan Commercial |
$6,513.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,166.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,901.70
|
|
|
AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION [35775]
|
Facility
OP
|
$8,685.12
|
|
|
Service Code
|
CPT J0180
|
| Hospital Charge Code |
1755755
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$200.85 |
| Max. Negotiated Rate |
$6,513.84 |
| Rate for Payer: Adventist Health Commercial |
$1,737.02
|
| Rate for Payer: Aetna of CA Gatekeeper |
$536.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,966.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$272.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$240.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$240.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$254.32
|
| Rate for Payer: Blue Shield of California Commercial |
$200.85
|
| Rate for Payer: Blue Shield of California EPN |
$200.85
|
| Rate for Payer: Cash Price |
$3,908.30
|
| Rate for Payer: Cash Price |
$3,908.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,995.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$327.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$240.18
|
| Rate for Payer: Dignity Health Senior |
$240.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,558.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$218.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,021.21
|
| Rate for Payer: Heritage Provider Network Senior |
$4,021.21
|
| Rate for Payer: Humana Medicare |
$218.34
|
| Rate for Payer: IEHP Medi-Cal |
$347.57
|
| Rate for Payer: IEHP Medicare Advantage |
$218.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$414.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,572.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$257.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,171.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.11
|
| Rate for Payer: Multiplan Commercial |
$6,513.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$240.18
|
| Rate for Payer: TriValley Medical Group Senior |
$218.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,166.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,901.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$327.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$240.18
|
| Rate for Payer: Vantage Medical Group Senior |
$218.34
|
|
|
AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION [38494]
|
Facility
IP
|
$1,240.52
|
|
|
Service Code
|
CPT J0180
|
| Hospital Charge Code |
1755754
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$224.53 |
| Max. Negotiated Rate |
$930.39 |
| Rate for Payer: Adventist Health Commercial |
$248.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$852.24
|
| Rate for Payer: Cash Price |
$558.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$570.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$839.83
|
| Rate for Payer: Heritage Provider Network Senior |
$839.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.13
|
| Rate for Payer: Multiplan Commercial |
$930.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$452.29
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$414.46
|
|
|
AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION [38494]
|
Facility
OP
|
$1,240.52
|
|
|
Service Code
|
CPT J0180
|
| Hospital Charge Code |
1755754
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$200.85 |
| Max. Negotiated Rate |
$930.39 |
| Rate for Payer: Adventist Health Commercial |
$248.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$536.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$852.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$272.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$240.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$240.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$254.32
|
| Rate for Payer: Blue Shield of California Commercial |
$200.85
|
| Rate for Payer: Blue Shield of California EPN |
$200.85
|
| Rate for Payer: Cash Price |
$558.23
|
| Rate for Payer: Cash Price |
$558.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$570.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$327.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$240.18
|
| Rate for Payer: Dignity Health Senior |
$240.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$218.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$574.36
|
| Rate for Payer: Heritage Provider Network Senior |
$574.36
|
| Rate for Payer: Humana Medicare |
$218.34
|
| Rate for Payer: IEHP Medi-Cal |
$347.57
|
| Rate for Payer: IEHP Medicare Advantage |
$218.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$414.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$257.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.11
|
| Rate for Payer: Multiplan Commercial |
$930.39
|
| Rate for Payer: TriValley Medical Group Commercial |
$240.18
|
| Rate for Payer: TriValley Medical Group Senior |
$218.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$452.29
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$414.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$327.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$240.18
|
| Rate for Payer: Vantage Medical Group Senior |
$218.34
|
|
|
AGAR (BULK) 100 % POWDER [40822641]
|
Facility
IP
|
$0.17
|
|
|
Service Code
|
NDC 9999-9226-41
|
| Hospital Charge Code |
1713148
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.12
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.12
|
| Rate for Payer: Heritage Provider Network Senior |
$0.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.13
|
|
|
AGAR (BULK) 100 % POWDER [40822641]
|
Facility
OP
|
$0.17
|
|
|
Service Code
|
NDC 9999-9226-41
|
| Hospital Charge Code |
1713148
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.09
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.14
|
| Rate for Payer: Dignity Health Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.11
|
| Rate for Payer: Heritage Provider Network Senior |
$0.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Vantage Medical Group Senior |
$0.14
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 0JH809Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 0JH639Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 0JPT3PZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 0JH839Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 0JPT0PZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
AICD Device (IP) - #2067
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 0JH609Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
ALBENDAZOLE 200 MG TABLET [8979]
|
Facility
IP
|
$35.85
|
|
|
Service Code
|
NDC 72205-051-08
|
| Hospital Charge Code |
1712227
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$26.89 |
| Rate for Payer: Adventist Health Commercial |
$7.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.63
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.27
|
| Rate for Payer: Heritage Provider Network Senior |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.96
|
| Rate for Payer: Multiplan Commercial |
$26.89
|
|
|
ALBENDAZOLE 200 MG TABLET [8979]
|
Facility
OP
|
$35.85
|
|
|
Service Code
|
NDC 72205-051-08
|
| Hospital Charge Code |
1712227
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$30.47 |
| Rate for Payer: Adventist Health Commercial |
$7.17
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26.89
|
| Rate for Payer: Blue Shield of California Commercial |
$22.26
|
| Rate for Payer: Blue Shield of California EPN |
$21.04
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.47
|
| Rate for Payer: Dignity Health Senior |
$30.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.19
|
| Rate for Payer: Heritage Provider Network Senior |
$22.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.96
|
| Rate for Payer: Multiplan Commercial |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.47
|
| Rate for Payer: Vantage Medical Group Senior |
$30.47
|
|
|
ALBENDAZOLE 200 MG TABLET [8979]
|
Facility
IP
|
$36.00
|
|
|
Service Code
|
NDC 31722-935-02
|
| Hospital Charge Code |
1712227
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.73
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.37
|
| Rate for Payer: Heritage Provider Network Senior |
$24.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
|
|
ALBENDAZOLE 200 MG TABLET [8979]
|
Facility
OP
|
$36.00
|
|
|
Service Code
|
NDC 31722-935-02
|
| Hospital Charge Code |
1712227
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22.36
|
| Rate for Payer: Blue Shield of California EPN |
$21.13
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.60
|
| Rate for Payer: Dignity Health Senior |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.28
|
| Rate for Payer: Heritage Provider Network Senior |
$22.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.60
|
| Rate for Payer: Vantage Medical Group Senior |
$30.60
|
|
|
ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]
|
Facility
OP
|
$1.39
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$130.40 |
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.82
|
| Rate for Payer: Blue Shield of California EPN |
$0.66
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.52
|
| Rate for Payer: Heritage Provider Network Senior |
$0.64
|
| Rate for Payer: Heritage Provider Network Senior |
$0.52
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
|
|
ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]
|
Facility
IP
|
$1.12
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.76
|
| Rate for Payer: Heritage Provider Network Senior |
$0.94
|
| Rate for Payer: Heritage Provider Network Senior |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
|
|
ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]
|
Facility
IP
|
$1.12
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.76
|
| Rate for Payer: Heritage Provider Network Senior |
$0.76
|
| Rate for Payer: Heritage Provider Network Senior |
$0.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
|
|
ALBUMIN, HUMAN 25% CONTINUOUS INTRAVENOUS SOLUTION [4088981]
|
Facility
OP
|
$1.12
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$130.40 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.64
|
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.82
|
| Rate for Payer: Blue Shield of California EPN |
$0.66
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.64
|
| Rate for Payer: Heritage Provider Network Senior |
$0.52
|
| Rate for Payer: Heritage Provider Network Senior |
$0.64
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [8981]
|
Facility
IP
|
$1.39
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$1.04 |
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.76
|
| Rate for Payer: Heritage Provider Network Senior |
$0.94
|
| Rate for Payer: Heritage Provider Network Senior |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [8981]
|
Facility
OP
|
$1.39
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
1770003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$130.40 |
| Rate for Payer: Adventist Health Commercial |
$0.28
|
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$66.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.64
|
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.82
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: Dignity Health Senior |
$58.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$53.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.52
|
| Rate for Payer: Heritage Provider Network Senior |
$0.64
|
| Rate for Payer: Heritage Provider Network Senior |
$0.52
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: Humana Medicare |
$53.08
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medi-Cal |
$82.80
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: IEHP Medicare Advantage |
$53.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$100.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.88
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: Multiplan Commercial |
$1.04
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$58.38
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: TriValley Medical Group Senior |
$53.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.38
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
| Rate for Payer: Vantage Medical Group Senior |
$53.08
|
|
