Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code NDC 71288-700-06
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.17
Max. Negotiated Rate $0.72
Rate for Payer: Adventist Health Commercial $0.19
Rate for Payer: Cash Price $0.53
Rate for Payer: EPIC Health Plan Commercial $0.52
Rate for Payer: Heritage Provider Network Commercial $0.65
Rate for Payer: Heritage Provider Network Senior $0.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.17
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Multiplan Commercial $0.72
Service Code NDC 71288-700-06
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.17
Max. Negotiated Rate $0.82
Rate for Payer: Adventist Health Commercial $0.19
Rate for Payer: Aetna of CA Gatekeeper $0.51
Rate for Payer: Aetna of CA Non-Gatekeeper $0.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.82
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.53
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.72
Rate for Payer: Blue Shield of California Commercial $0.59
Rate for Payer: Blue Shield of California EPN $0.47
Rate for Payer: Cash Price $0.53
Rate for Payer: Cigna of CA HMO/PPO $0.62
Rate for Payer: Dignity Health Commercial/Exchange $0.82
Rate for Payer: Dignity Health Medi-Cal $0.82
Rate for Payer: Dignity Health Senior $0.82
Rate for Payer: EPIC Health Plan Commercial $0.61
Rate for Payer: Heritage Provider Network Commercial $0.59
Rate for Payer: Heritage Provider Network Senior $0.59
Rate for Payer: Kaiser Permanente of CA Commercial $0.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.17
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.67
Rate for Payer: Molina Healthcare of CA Medicare $0.67
Rate for Payer: Multiplan Commercial $0.72
Rate for Payer: TriValley Medical Group Commercial $0.38
Rate for Payer: TriValley Medical Group Senior $0.38
Rate for Payer: United Healthcare All Other HMO/non HMO $0.48
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.48
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.82
Rate for Payer: Vantage Medical Group Medi-Cal $0.82
Rate for Payer: Vantage Medical Group Senior $0.82
Service Code NDC 71839-141-01
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.58
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Cash Price $0.42
Rate for Payer: EPIC Health Plan Commercial $0.42
Rate for Payer: Heritage Provider Network Commercial $0.52
Rate for Payer: Heritage Provider Network Senior $0.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Multiplan Commercial $0.58
Service Code NDC 71839-141-01
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Aetna of CA Gatekeeper $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $0.53
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.42
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.58
Rate for Payer: Blue Shield of California Commercial $0.47
Rate for Payer: Blue Shield of California EPN $0.38
Rate for Payer: Cash Price $0.42
Rate for Payer: Cigna of CA HMO/PPO $0.50
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: Dignity Health Medi-Cal $0.65
Rate for Payer: Dignity Health Senior $0.65
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.48
Rate for Payer: Heritage Provider Network Senior $0.48
Rate for Payer: Kaiser Permanente of CA Commercial $0.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.54
Rate for Payer: Molina Healthcare of CA Medicare $0.54
Rate for Payer: Multiplan Commercial $0.58
Rate for Payer: TriValley Medical Group Commercial $0.31
Rate for Payer: TriValley Medical Group Senior $0.31
Rate for Payer: United Healthcare All Other HMO/non HMO $0.39
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.39
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.65
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 71839-141-10
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.58
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Cash Price $0.42
Rate for Payer: EPIC Health Plan Commercial $0.42
Rate for Payer: Heritage Provider Network Commercial $0.52
Rate for Payer: Heritage Provider Network Senior $0.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Multiplan Commercial $0.58
Service Code NDC 71839-141-10
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Adventist Health Commercial $0.15
Rate for Payer: Aetna of CA Gatekeeper $0.41
Rate for Payer: Aetna of CA Non-Gatekeeper $0.53
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.42
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.58
Rate for Payer: Blue Shield of California Commercial $0.47
Rate for Payer: Blue Shield of California EPN $0.38
Rate for Payer: Cash Price $0.42
Rate for Payer: Cigna of CA HMO/PPO $0.50
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: Dignity Health Medi-Cal $0.65
Rate for Payer: Dignity Health Senior $0.65
Rate for Payer: EPIC Health Plan Commercial $0.49
Rate for Payer: Heritage Provider Network Commercial $0.48
Rate for Payer: Heritage Provider Network Senior $0.48
Rate for Payer: Kaiser Permanente of CA Commercial $0.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.19
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.54
Rate for Payer: Molina Healthcare of CA Medicare $0.54
Rate for Payer: Multiplan Commercial $0.58
Rate for Payer: TriValley Medical Group Commercial $0.31
Rate for Payer: TriValley Medical Group Senior $0.31
Rate for Payer: United Healthcare All Other HMO/non HMO $0.39
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.39
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.65
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 67457-228-05
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.99
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Aetna of CA Gatekeeper $0.62
Rate for Payer: Aetna of CA Non-Gatekeeper $0.80
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.99
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.64
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.87
Rate for Payer: Blue Shield of California Commercial $0.71
Rate for Payer: Blue Shield of California EPN $0.57
Rate for Payer: Cash Price $0.64
Rate for Payer: Cigna of CA HMO/PPO $0.75
Rate for Payer: Dignity Health Commercial/Exchange $0.99
Rate for Payer: Dignity Health Medi-Cal $0.99
Rate for Payer: Dignity Health Senior $0.99
Rate for Payer: EPIC Health Plan Commercial $0.74
Rate for Payer: Heritage Provider Network Commercial $0.72
Rate for Payer: Heritage Provider Network Senior $0.72
Rate for Payer: Kaiser Permanente of CA Commercial $0.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.81
Rate for Payer: Molina Healthcare of CA Medicare $0.81
Rate for Payer: Multiplan Commercial $0.87
Rate for Payer: TriValley Medical Group Commercial $0.46
Rate for Payer: TriValley Medical Group Senior $0.46
Rate for Payer: United Healthcare All Other HMO/non HMO $0.58
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.58
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.99
Rate for Payer: Vantage Medical Group Medi-Cal $0.99
Rate for Payer: Vantage Medical Group Senior $0.99
Service Code NDC 71288-700-05
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.17
Max. Negotiated Rate $0.72
Rate for Payer: Adventist Health Commercial $0.19
Rate for Payer: Cash Price $0.53
Rate for Payer: EPIC Health Plan Commercial $0.52
Rate for Payer: Heritage Provider Network Commercial $0.65
Rate for Payer: Heritage Provider Network Senior $0.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.17
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Multiplan Commercial $0.72
Service Code NDC 67457-228-05
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.87
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Cash Price $0.64
Rate for Payer: EPIC Health Plan Commercial $0.63
Rate for Payer: Heritage Provider Network Commercial $0.79
Rate for Payer: Heritage Provider Network Senior $0.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $0.87
Service Code NDC 67457-228-00
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.87
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Cash Price $0.64
Rate for Payer: EPIC Health Plan Commercial $0.63
Rate for Payer: Heritage Provider Network Commercial $0.79
Rate for Payer: Heritage Provider Network Senior $0.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $0.87
Service Code NDC 67457-228-00
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.99
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Aetna of CA Gatekeeper $0.62
Rate for Payer: Aetna of CA Non-Gatekeeper $0.80
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.99
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.64
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.87
Rate for Payer: Blue Shield of California Commercial $0.71
Rate for Payer: Blue Shield of California EPN $0.57
Rate for Payer: Cash Price $0.64
Rate for Payer: Cigna of CA HMO/PPO $0.75
Rate for Payer: Dignity Health Commercial/Exchange $0.99
Rate for Payer: Dignity Health Medi-Cal $0.99
Rate for Payer: Dignity Health Senior $0.99
Rate for Payer: EPIC Health Plan Commercial $0.74
Rate for Payer: Heritage Provider Network Commercial $0.72
Rate for Payer: Heritage Provider Network Senior $0.72
Rate for Payer: Kaiser Permanente of CA Commercial $0.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.81
Rate for Payer: Molina Healthcare of CA Medicare $0.81
Rate for Payer: Multiplan Commercial $0.87
Rate for Payer: TriValley Medical Group Commercial $0.46
Rate for Payer: TriValley Medical Group Senior $0.46
Rate for Payer: United Healthcare All Other HMO/non HMO $0.58
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.58
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.99
Rate for Payer: Vantage Medical Group Medi-Cal $0.99
Rate for Payer: Vantage Medical Group Senior $0.99
Service Code NDC 67457-228-05
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.87
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Cash Price $0.64
Rate for Payer: EPIC Health Plan Commercial $0.63
Rate for Payer: Heritage Provider Network Commercial $0.79
Rate for Payer: Heritage Provider Network Senior $0.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $0.87
Service Code NDC 67457-228-05
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.99
Rate for Payer: Adventist Health Commercial $0.23
Rate for Payer: Aetna of CA Gatekeeper $0.62
Rate for Payer: Aetna of CA Non-Gatekeeper $0.80
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.99
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.64
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.87
Rate for Payer: Blue Shield of California Commercial $0.71
Rate for Payer: Blue Shield of California EPN $0.57
Rate for Payer: Cash Price $0.64
Rate for Payer: Cigna of CA HMO/PPO $0.75
Rate for Payer: Dignity Health Commercial/Exchange $0.99
Rate for Payer: Dignity Health Medi-Cal $0.99
Rate for Payer: Dignity Health Senior $0.99
Rate for Payer: EPIC Health Plan Commercial $0.74
Rate for Payer: Heritage Provider Network Commercial $0.72
Rate for Payer: Heritage Provider Network Senior $0.72
Rate for Payer: Kaiser Permanente of CA Commercial $0.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.81
Rate for Payer: Molina Healthcare of CA Medicare $0.81
Rate for Payer: Multiplan Commercial $0.87
Rate for Payer: TriValley Medical Group Commercial $0.46
Rate for Payer: TriValley Medical Group Senior $0.46
Rate for Payer: United Healthcare All Other HMO/non HMO $0.58
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.58
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.99
Rate for Payer: Vantage Medical Group Medi-Cal $0.99
Rate for Payer: Vantage Medical Group Senior $0.99
Service Code NDC 72205-200-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.14
Rate for Payer: Cash Price $0.40
Rate for Payer: EPIC Health Plan Commercial $0.39
Rate for Payer: Heritage Provider Network Commercial $0.49
Rate for Payer: Heritage Provider Network Senior $0.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.54
Service Code NDC 0310-0095-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $3.31
Max. Negotiated Rate $15.54
Rate for Payer: Adventist Health Commercial $3.66
Rate for Payer: Aetna of CA Gatekeeper $9.77
Rate for Payer: Aetna of CA Non-Gatekeeper $12.56
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $15.54
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.05
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $13.71
Rate for Payer: Blue Shield of California Commercial $11.15
Rate for Payer: Blue Shield of California EPN $8.92
Rate for Payer: Cash Price $10.06
Rate for Payer: Cigna of CA HMO/PPO $11.88
Rate for Payer: Dignity Health Commercial/Exchange $15.54
Rate for Payer: Dignity Health Medi-Cal $15.54
Rate for Payer: Dignity Health Senior $15.54
Rate for Payer: EPIC Health Plan Commercial $11.70
Rate for Payer: Heritage Provider Network Commercial $11.32
Rate for Payer: Heritage Provider Network Senior $11.32
Rate for Payer: Kaiser Permanente of CA Commercial $8.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3.31
Rate for Payer: LLUH Dept of Risk Management WC $4.57
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.80
Rate for Payer: Molina Healthcare of CA Medicare $12.80
Rate for Payer: Multiplan Commercial $13.71
Rate for Payer: TriValley Medical Group Commercial $7.31
Rate for Payer: TriValley Medical Group Senior $7.31
Rate for Payer: United Healthcare All Other HMO/non HMO $9.14
Rate for Payer: United Healthcare Navigate/Select/Select+ $9.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $15.54
Rate for Payer: Vantage Medical Group Medi-Cal $15.54
Rate for Payer: Vantage Medical Group Senior $15.54
Service Code NDC 0310-0095-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $3.31
Max. Negotiated Rate $13.71
Rate for Payer: Adventist Health Commercial $3.66
Rate for Payer: Cash Price $10.06
Rate for Payer: EPIC Health Plan Commercial $9.87
Rate for Payer: Heritage Provider Network Commercial $12.38
Rate for Payer: Heritage Provider Network Senior $12.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3.31
Rate for Payer: LLUH Dept of Risk Management WC $4.57
Rate for Payer: Multiplan Commercial $13.71
Service Code NDC 72205-200-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.61
Rate for Payer: Adventist Health Commercial $0.14
Rate for Payer: Aetna of CA Gatekeeper $0.38
Rate for Payer: Aetna of CA Non-Gatekeeper $0.49
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.40
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.54
Rate for Payer: Blue Shield of California Commercial $0.44
Rate for Payer: Blue Shield of California EPN $0.35
Rate for Payer: Cash Price $0.40
Rate for Payer: Cigna of CA HMO/PPO $0.47
Rate for Payer: Dignity Health Commercial/Exchange $0.61
Rate for Payer: Dignity Health Medi-Cal $0.61
Rate for Payer: Dignity Health Senior $0.61
Rate for Payer: EPIC Health Plan Commercial $0.46
Rate for Payer: Heritage Provider Network Commercial $0.45
Rate for Payer: Heritage Provider Network Senior $0.45
Rate for Payer: Kaiser Permanente of CA Commercial $0.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.50
Rate for Payer: Molina Healthcare of CA Medicare $0.50
Rate for Payer: Multiplan Commercial $0.54
Rate for Payer: TriValley Medical Group Commercial $0.29
Rate for Payer: TriValley Medical Group Senior $0.29
Rate for Payer: United Healthcare All Other HMO/non HMO $0.36
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.36
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.61
Rate for Payer: Vantage Medical Group Medi-Cal $0.61
Rate for Payer: Vantage Medical Group Senior $0.61
Service Code NDC 60687-577-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.50
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Cash Price $0.36
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: Heritage Provider Network Commercial $0.45
Rate for Payer: Heritage Provider Network Senior $0.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Multiplan Commercial $0.50
Service Code NDC 60687-577-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.50
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Cash Price $0.36
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: Heritage Provider Network Commercial $0.45
Rate for Payer: Heritage Provider Network Senior $0.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Multiplan Commercial $0.50
Service Code NDC 0904-6373-61
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.44
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Cash Price $0.32
Rate for Payer: EPIC Health Plan Commercial $0.32
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 Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.44
Service Code NDC 60687-577-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.56
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Aetna of CA Gatekeeper $0.35
Rate for Payer: Aetna of CA Non-Gatekeeper $0.45
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.56
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.36
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: Blue Shield of California Commercial $0.40
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.36
Rate for Payer: Cigna of CA HMO/PPO $0.43
Rate for Payer: Dignity Health Commercial/Exchange $0.56
Rate for Payer: Dignity Health Medi-Cal $0.56
Rate for Payer: Dignity Health Senior $0.56
Rate for Payer: EPIC Health Plan Commercial $0.42
Rate for Payer: Heritage Provider Network Commercial $0.41
Rate for Payer: Heritage Provider Network Senior $0.41
Rate for Payer: Kaiser Permanente of CA Commercial $0.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.46
Rate for Payer: Molina Healthcare of CA Medicare $0.46
Rate for Payer: Multiplan Commercial $0.50
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 $0.33
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.33
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.56
Rate for Payer: Vantage Medical Group Medi-Cal $0.56
Rate for Payer: Vantage Medical Group Senior $0.56
Service Code NDC 60687-577-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.56
Rate for Payer: Adventist Health Commercial $0.13
Rate for Payer: Aetna of CA Gatekeeper $0.35
Rate for Payer: Aetna of CA Non-Gatekeeper $0.45
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.56
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.36
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: Blue Shield of California Commercial $0.40
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.36
Rate for Payer: Cigna of CA HMO/PPO $0.43
Rate for Payer: Dignity Health Commercial/Exchange $0.56
Rate for Payer: Dignity Health Medi-Cal $0.56
Rate for Payer: Dignity Health Senior $0.56
Rate for Payer: EPIC Health Plan Commercial $0.42
Rate for Payer: Heritage Provider Network Commercial $0.41
Rate for Payer: Heritage Provider Network Senior $0.41
Rate for Payer: Kaiser Permanente of CA Commercial $0.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.46
Rate for Payer: Molina Healthcare of CA Medicare $0.46
Rate for Payer: Multiplan Commercial $0.50
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 $0.33
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.33
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.56
Rate for Payer: Vantage Medical Group Medi-Cal $0.56
Rate for Payer: Vantage Medical Group Senior $0.56
Service Code NDC 62332-030-31
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 62332-030-31
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
Service Code NDC 0904-6373-61
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.50
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA Gatekeeper $0.32
Rate for Payer: Aetna of CA Non-Gatekeeper $0.41
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.50
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.32
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.44
Rate for Payer: Blue Shield of California Commercial $0.36
Rate for Payer: Blue Shield of California EPN $0.29
Rate for Payer: Cash Price $0.32
Rate for Payer: Cigna of CA HMO/PPO $0.38
Rate for Payer: Dignity Health Commercial/Exchange $0.50
Rate for Payer: Dignity Health Medi-Cal $0.50
Rate for Payer: Dignity Health Senior $0.50
Rate for Payer: EPIC Health Plan Commercial $0.38
Rate for Payer: Heritage Provider Network Commercial $0.37
Rate for Payer: Heritage Provider Network Senior $0.37
Rate for Payer: Kaiser Permanente of CA Commercial $0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.41
Rate for Payer: Molina Healthcare of CA Medicare $0.41
Rate for Payer: Multiplan Commercial $0.44
Rate for Payer: TriValley Medical Group Commercial $0.24
Rate for Payer: TriValley Medical Group Senior $0.24
Rate for Payer: United Healthcare All Other HMO/non HMO $0.30
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.50
Rate for Payer: Vantage Medical Group Medi-Cal $0.50
Rate for Payer: Vantage Medical Group Senior $0.50