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Service Code NDC 8770140730
Hospital Charge Code 901700029
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: 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 Medicare Advantage/Dual Product $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.02
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: Molina Healthcare of CA Medi-Cal $0.02
Rate for Payer: Molina Healthcare of CA Medicare $0.02
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Senior $0.01
Rate for Payer: United Healthcare All Other HMO/non HMO $0.02
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.02
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 Senior $0.03
Service Code NDC 0536440601
Hospital Charge Code 901700029
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: 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 Medicare Advantage/Dual Product $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
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: Molina Healthcare of CA Medi-Cal $0.02
Rate for Payer: Molina Healthcare of CA Medicare $0.02
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Senior $0.01
Rate for Payer: United Healthcare All Other HMO/non HMO $0.02
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.02
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 Senior $0.03
Service Code NDC 0536440601
Hospital Charge Code 901700029
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: 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 5026885811
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.24
Rate for Payer: Adventist Health Commercial $0.06
Rate for Payer: Aetna of CA Gatekeeper $0.15
Rate for Payer: Aetna of CA Non-Gatekeeper $0.19
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.24
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.15
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.21
Rate for Payer: Blue Shield of California Commercial $0.17
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.16
Rate for Payer: Cigna of CA HMO/PPO $0.18
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: Dignity Health Senior $0.24
Rate for Payer: EPIC Health Plan Commercial $0.18
Rate for Payer: Heritage Provider Network Commercial $0.17
Rate for Payer: Heritage Provider Network Senior $0.17
Rate for Payer: Kaiser Permanente of CA Commercial $0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.20
Rate for Payer: Molina Healthcare of CA Medicare $0.20
Rate for Payer: Multiplan Commercial $0.21
Rate for Payer: TriValley Medical Group Commercial $0.11
Rate for Payer: TriValley Medical Group Senior $0.11
Rate for Payer: United Healthcare All Other HMO/non HMO $0.14
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 5026885815
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.21
Rate for Payer: Adventist Health Commercial $0.06
Rate for Payer: Cash Price $0.16
Rate for Payer: EPIC Health Plan Commercial $0.15
Rate for Payer: Heritage Provider Network Commercial $0.19
Rate for Payer: Heritage Provider Network Senior $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.21
Service Code NDC 5026885815
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.24
Rate for Payer: Adventist Health Commercial $0.06
Rate for Payer: Aetna of CA Gatekeeper $0.15
Rate for Payer: Aetna of CA Non-Gatekeeper $0.19
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.24
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.15
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.21
Rate for Payer: Blue Shield of California Commercial $0.17
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.16
Rate for Payer: Cigna of CA HMO/PPO $0.18
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: Dignity Health Senior $0.24
Rate for Payer: EPIC Health Plan Commercial $0.18
Rate for Payer: Heritage Provider Network Commercial $0.17
Rate for Payer: Heritage Provider Network Senior $0.17
Rate for Payer: Kaiser Permanente of CA Commercial $0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.20
Rate for Payer: Molina Healthcare of CA Medicare $0.20
Rate for Payer: Multiplan Commercial $0.21
Rate for Payer: TriValley Medical Group Commercial $0.11
Rate for Payer: TriValley Medical Group Senior $0.11
Rate for Payer: United Healthcare All Other HMO/non HMO $0.14
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 5789685301
Hospital Charge Code 901700029
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: Alpha Care Medical Group Commercial/Exchange $0.02
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.01
Rate for Payer: Alpha Care 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: Molina Healthcare of CA Medi-Cal $0.01
Rate for Payer: Molina Healthcare of CA Medicare $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Senior $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: Vantage Medical Group Commercial/Exchange $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 5026885811
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.21
Rate for Payer: Adventist Health Commercial $0.06
Rate for Payer: Cash Price $0.16
Rate for Payer: EPIC Health Plan Commercial $0.15
Rate for Payer: Heritage Provider Network Commercial $0.19
Rate for Payer: Heritage Provider Network Senior $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.21
Service Code NDC 5789685301
Hospital Charge Code 901700029
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.00
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
Service Code NDC 9994-0811-40
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $3.60
Max. Negotiated Rate $14.91
Rate for Payer: Adventist Health Commercial $3.98
Rate for Payer: Cash Price $10.94
Rate for Payer: EPIC Health Plan Commercial $10.74
Rate for Payer: Heritage Provider Network Commercial $13.46
Rate for Payer: Heritage Provider Network Senior $13.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3.60
Rate for Payer: LLUH Dept of Risk Management WC $4.97
Rate for Payer: Multiplan Commercial $14.91
Service Code NDC 9994-0811-40
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $3.60
Max. Negotiated Rate $16.90
Rate for Payer: Adventist Health Commercial $3.98
Rate for Payer: Aetna of CA Gatekeeper $10.63
Rate for Payer: Aetna of CA Non-Gatekeeper $13.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $16.90
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.93
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $14.91
Rate for Payer: Blue Shield of California Commercial $12.13
Rate for Payer: Blue Shield of California EPN $9.70
Rate for Payer: Cash Price $10.94
Rate for Payer: Cigna of CA HMO/PPO $12.92
Rate for Payer: Dignity Health Commercial/Exchange $16.90
Rate for Payer: Dignity Health Medi-Cal $16.90
Rate for Payer: Dignity Health Senior $16.90
Rate for Payer: EPIC Health Plan Commercial $12.72
Rate for Payer: Heritage Provider Network Commercial $12.31
Rate for Payer: Heritage Provider Network Senior $12.31
Rate for Payer: Kaiser Permanente of CA Commercial $9.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3.60
Rate for Payer: LLUH Dept of Risk Management WC $4.97
Rate for Payer: Molina Healthcare of CA Medi-Cal $13.92
Rate for Payer: Molina Healthcare of CA Medicare $13.92
Rate for Payer: Multiplan Commercial $14.91
Rate for Payer: TriValley Medical Group Commercial $7.95
Rate for Payer: TriValley Medical Group Senior $7.95
Rate for Payer: United Healthcare All Other HMO/non HMO $9.94
Rate for Payer: United Healthcare Navigate/Select/Select+ $9.94
Rate for Payer: Vantage Medical Group Commercial/Exchange $16.90
Rate for Payer: Vantage Medical Group Medi-Cal $16.90
Rate for Payer: Vantage Medical Group Senior $16.90
Service Code NDC 0480-3720-56
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $55.71
Max. Negotiated Rate $261.63
Rate for Payer: Adventist Health Commercial $61.56
Rate for Payer: Aetna of CA Gatekeeper $164.52
Rate for Payer: Aetna of CA Non-Gatekeeper $211.46
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $261.63
Rate for Payer: Alpha Care Medical Group Medi-Cal $169.29
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $230.85
Rate for Payer: Blue Shield of California Commercial $187.76
Rate for Payer: Blue Shield of California EPN $150.21
Rate for Payer: Cash Price $169.29
Rate for Payer: Cigna of CA HMO/PPO $200.07
Rate for Payer: Dignity Health Commercial/Exchange $261.63
Rate for Payer: Dignity Health Medi-Cal $261.63
Rate for Payer: Dignity Health Senior $261.63
Rate for Payer: EPIC Health Plan Commercial $196.99
Rate for Payer: Heritage Provider Network Commercial $190.53
Rate for Payer: Heritage Provider Network Senior $190.53
Rate for Payer: Kaiser Permanente of CA Commercial $146.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal $55.71
Rate for Payer: LLUH Dept of Risk Management WC $76.95
Rate for Payer: Molina Healthcare of CA Medi-Cal $215.46
Rate for Payer: Molina Healthcare of CA Medicare $215.46
Rate for Payer: Multiplan Commercial $230.85
Rate for Payer: TriValley Medical Group Commercial $123.12
Rate for Payer: TriValley Medical Group Senior $123.12
Rate for Payer: United Healthcare All Other HMO/non HMO $153.90
Rate for Payer: United Healthcare Navigate/Select/Select+ $153.90
Rate for Payer: Vantage Medical Group Commercial/Exchange $261.63
Rate for Payer: Vantage Medical Group Medi-Cal $261.63
Rate for Payer: Vantage Medical Group Senior $261.63
Service Code NDC 0480-3720-56
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $55.71
Max. Negotiated Rate $230.85
Rate for Payer: Adventist Health Commercial $61.56
Rate for Payer: Cash Price $169.29
Rate for Payer: EPIC Health Plan Commercial $166.21
Rate for Payer: Heritage Provider Network Commercial $208.38
Rate for Payer: Heritage Provider Network Senior $208.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $55.71
Rate for Payer: LLUH Dept of Risk Management WC $76.95
Rate for Payer: Multiplan Commercial $230.85
Service Code NDC 9994-0803-28
Hospital Charge Code 901700029
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: Alpha Care Medical Group Commercial/Exchange $0.08
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.05
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.05
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: Molina Healthcare of CA Medi-Cal $0.06
Rate for Payer: Molina Healthcare of CA Medicare $0.06
Rate for Payer: Multiplan Commercial $0.07
Rate for Payer: TriValley Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Senior $0.04
Rate for Payer: United Healthcare All Other HMO/non HMO $0.05
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.05
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.08
Rate for Payer: Vantage Medical Group Medi-Cal $0.08
Rate for Payer: Vantage Medical Group Senior $0.08
Service Code NDC 9994-0803-28
Hospital Charge Code 901700029
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: Cash Price $0.05
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 60687-349-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Aetna of CA Gatekeeper $0.34
Rate for Payer: Aetna of CA Non-Gatekeeper $0.44
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.54
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.35
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.48
Rate for Payer: Blue Shield of California Commercial $0.39
Rate for Payer: Blue Shield of California EPN $0.31
Rate for Payer: Cash Price $0.35
Rate for Payer: Cigna of CA HMO/PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.54
Rate for Payer: Dignity Health Medi-Cal $0.54
Rate for Payer: Dignity Health Senior $0.54
Rate for Payer: EPIC Health Plan Commercial $0.41
Rate for Payer: Heritage Provider Network Commercial $0.40
Rate for Payer: Heritage Provider Network Senior $0.40
Rate for Payer: Kaiser Permanente of CA Commercial $0.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.45
Rate for Payer: Molina Healthcare of CA Medicare $0.45
Rate for Payer: Multiplan Commercial $0.48
Rate for Payer: TriValley Medical Group Commercial $0.26
Rate for Payer: TriValley Medical Group Senior $0.26
Rate for Payer: United Healthcare All Other HMO/non HMO $0.32
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.32
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.54
Rate for Payer: Vantage Medical Group Medi-Cal $0.54
Rate for Payer: Vantage Medical Group Senior $0.54
Service Code NDC 60687-349-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.48
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Cash Price $0.35
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Heritage Provider Network Commercial $0.43
Rate for Payer: Heritage Provider Network Senior $0.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: Multiplan Commercial $0.48
Service Code NDC 60687-349-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Aetna of CA Gatekeeper $0.34
Rate for Payer: Aetna of CA Non-Gatekeeper $0.44
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.54
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.35
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.48
Rate for Payer: Blue Shield of California Commercial $0.39
Rate for Payer: Blue Shield of California EPN $0.31
Rate for Payer: Cash Price $0.35
Rate for Payer: Cigna of CA HMO/PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.54
Rate for Payer: Dignity Health Medi-Cal $0.54
Rate for Payer: Dignity Health Senior $0.54
Rate for Payer: EPIC Health Plan Commercial $0.41
Rate for Payer: Heritage Provider Network Commercial $0.40
Rate for Payer: Heritage Provider Network Senior $0.40
Rate for Payer: Kaiser Permanente of CA Commercial $0.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.45
Rate for Payer: Molina Healthcare of CA Medicare $0.45
Rate for Payer: Multiplan Commercial $0.48
Rate for Payer: TriValley Medical Group Commercial $0.26
Rate for Payer: TriValley Medical Group Senior $0.26
Rate for Payer: United Healthcare All Other HMO/non HMO $0.32
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.32
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.54
Rate for Payer: Vantage Medical Group Medi-Cal $0.54
Rate for Payer: Vantage Medical Group Senior $0.54
Service Code NDC 67877-250-01
Hospital Charge Code 901700029
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: Cash Price $0.05
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 60687-349-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.48
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Cash Price $0.35
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Heritage Provider Network Commercial $0.43
Rate for Payer: Heritage Provider Network Senior $0.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: Multiplan Commercial $0.48
Service Code NDC 47335-904-88
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.32
Rate for Payer: Adventist Health Commercial $0.08
Rate for Payer: Aetna of CA Gatekeeper $0.20
Rate for Payer: Aetna of CA Non-Gatekeeper $0.26
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.32
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.21
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.29
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.19
Rate for Payer: Cash Price $0.21
Rate for Payer: Cigna of CA HMO/PPO $0.25
Rate for Payer: Dignity Health Commercial/Exchange $0.32
Rate for Payer: Dignity Health Medi-Cal $0.32
Rate for Payer: Dignity Health Senior $0.32
Rate for Payer: EPIC Health Plan Commercial $0.24
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 Commercial $0.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.27
Rate for Payer: Molina Healthcare of CA Medicare $0.27
Rate for Payer: Multiplan Commercial $0.29
Rate for Payer: TriValley Medical Group Commercial $0.15
Rate for Payer: TriValley Medical Group Senior $0.15
Rate for Payer: United Healthcare All Other HMO/non HMO $0.19
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.19
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.32
Rate for Payer: Vantage Medical Group Medi-Cal $0.32
Rate for Payer: Vantage Medical Group Senior $0.32
Service Code NDC 0904-6640-61
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.42
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Cash Price $0.31
Rate for Payer: EPIC Health Plan Commercial $0.30
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 Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.42
Service Code NDC 0904-6640-61
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.48
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Aetna of CA Gatekeeper $0.30
Rate for Payer: Aetna of CA Non-Gatekeeper $0.38
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.48
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.31
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.42
Rate for Payer: Blue Shield of California Commercial $0.34
Rate for Payer: Blue Shield of California EPN $0.27
Rate for Payer: Cash Price $0.31
Rate for Payer: Cigna of CA HMO/PPO $0.36
Rate for Payer: Dignity Health Commercial/Exchange $0.48
Rate for Payer: Dignity Health Medi-Cal $0.48
Rate for Payer: Dignity Health Senior $0.48
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: Heritage Provider Network Commercial $0.35
Rate for Payer: Heritage Provider Network Senior $0.35
Rate for Payer: Kaiser Permanente of CA Commercial $0.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.39
Rate for Payer: Molina Healthcare of CA Medicare $0.39
Rate for Payer: Multiplan Commercial $0.42
Rate for Payer: TriValley Medical Group Commercial $0.22
Rate for Payer: TriValley Medical Group Senior $0.22
Rate for Payer: United Healthcare All Other HMO/non HMO $0.28
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.28
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.48
Rate for Payer: Vantage Medical Group Medi-Cal $0.48
Rate for Payer: Vantage Medical Group Senior $0.48
Service Code NDC 16729-147-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.11
Rate for Payer: Adventist Health Commercial $0.03
Rate for Payer: Cash Price $0.08
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Heritage Provider Network Commercial $0.09
Rate for Payer: Heritage Provider Network Senior $0.09
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 $0.11
Service Code NDC 16729-147-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.12
Rate for Payer: Adventist Health Commercial $0.03
Rate for Payer: Aetna of CA Gatekeeper $0.07
Rate for Payer: Aetna of CA Non-Gatekeeper $0.10
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.12
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.08
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.11
Rate for Payer: Blue Shield of California Commercial $0.09
Rate for Payer: Blue Shield of California EPN $0.07
Rate for Payer: Cash Price $0.08
Rate for Payer: Cigna of CA HMO/PPO $0.09
Rate for Payer: Dignity Health Commercial/Exchange $0.12
Rate for Payer: Dignity Health Medi-Cal $0.12
Rate for Payer: Dignity Health Senior $0.12
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Heritage Provider Network Commercial $0.09
Rate for Payer: Heritage Provider Network Senior $0.09
Rate for Payer: Kaiser Permanente of CA Commercial $0.07
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: Molina Healthcare of CA Medi-Cal $0.10
Rate for Payer: Molina Healthcare of CA Medicare $0.10
Rate for Payer: Multiplan Commercial $0.11
Rate for Payer: TriValley Medical Group Commercial $0.06
Rate for Payer: TriValley Medical Group Senior $0.06
Rate for Payer: United Healthcare All Other HMO/non HMO $0.07
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.07
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.12
Rate for Payer: Vantage Medical Group Medi-Cal $0.12
Rate for Payer: Vantage Medical Group Senior $0.12