Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS J3030
Hospital Charge Code 901700025
Hospital Revenue Code 636
Min. Negotiated Rate $4.78
Max. Negotiated Rate $19.80
Rate for Payer: Adventist Health Commercial $5.28
Rate for Payer: Adventist Health Commercial $23.52
Rate for Payer: Cash Price $14.52
Rate for Payer: Cash Price $64.68
Rate for Payer: Cigna of CA HMO/PPO $12.14
Rate for Payer: Cigna of CA HMO/PPO $54.10
Rate for Payer: EPIC Health Plan Commercial $63.50
Rate for Payer: EPIC Health Plan Commercial $14.26
Rate for Payer: Heritage Provider Network Commercial $54.45
Rate for Payer: Heritage Provider Network Commercial $12.22
Rate for Payer: Heritage Provider Network Senior $12.22
Rate for Payer: Heritage Provider Network Senior $54.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal $21.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal $4.78
Rate for Payer: LLUH Dept of Risk Management WC $29.40
Rate for Payer: LLUH Dept of Risk Management WC $6.60
Rate for Payer: Multiplan Commercial $88.20
Rate for Payer: Multiplan Commercial $19.80
Rate for Payer: United Healthcare All Other HMO/non HMO $9.54
Rate for Payer: United Healthcare All Other HMO/non HMO $42.49
Rate for Payer: United Healthcare Navigate/Select/Select+ $38.94
Rate for Payer: United Healthcare Navigate/Select/Select+ $8.74
Service Code NDC 9994-0803-44
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.23
Max. Negotiated Rate $0.95
Rate for Payer: Adventist Health Commercial $0.25
Rate for Payer: Cash Price $0.69
Rate for Payer: EPIC Health Plan Commercial $0.68
Rate for Payer: Heritage Provider Network Commercial $0.85
Rate for Payer: Heritage Provider Network Senior $0.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: LLUH Dept of Risk Management WC $0.32
Rate for Payer: Multiplan Commercial $0.95
Service Code NDC 9994-0803-44
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.23
Max. Negotiated Rate $1.07
Rate for Payer: Adventist Health Commercial $0.25
Rate for Payer: Aetna of CA Gatekeeper $0.67
Rate for Payer: Aetna of CA Non-Gatekeeper $0.87
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $1.07
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.69
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.95
Rate for Payer: Blue Shield of California Commercial $0.77
Rate for Payer: Blue Shield of California EPN $0.61
Rate for Payer: Cash Price $0.69
Rate for Payer: Cigna of CA HMO/PPO $0.82
Rate for Payer: Dignity Health Commercial/Exchange $1.07
Rate for Payer: Dignity Health Medi-Cal $1.07
Rate for Payer: Dignity Health Senior $1.07
Rate for Payer: EPIC Health Plan Commercial $0.81
Rate for Payer: Heritage Provider Network Commercial $0.78
Rate for Payer: Heritage Provider Network Senior $0.78
Rate for Payer: Kaiser Permanente of CA Commercial $0.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: LLUH Dept of Risk Management WC $0.32
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.88
Rate for Payer: Molina Healthcare of CA Medicare $0.88
Rate for Payer: Multiplan Commercial $0.95
Rate for Payer: TriValley Medical Group Commercial $0.50
Rate for Payer: TriValley Medical Group Senior $0.50
Rate for Payer: United Healthcare All Other HMO/non HMO $0.63
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.63
Rate for Payer: Vantage Medical Group Commercial/Exchange $1.07
Rate for Payer: Vantage Medical Group Medi-Cal $1.07
Rate for Payer: Vantage Medical Group Senior $1.07
Service Code NDC 0069-0550-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $50.08
Max. Negotiated Rate $207.53
Rate for Payer: Adventist Health Commercial $55.34
Rate for Payer: Cash Price $152.19
Rate for Payer: EPIC Health Plan Commercial $149.42
Rate for Payer: Heritage Provider Network Commercial $187.33
Rate for Payer: Heritage Provider Network Senior $187.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal $50.08
Rate for Payer: LLUH Dept of Risk Management WC $69.17
Rate for Payer: Multiplan Commercial $207.53
Service Code NDC 0069-0550-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $50.08
Max. Negotiated Rate $235.19
Rate for Payer: Adventist Health Commercial $55.34
Rate for Payer: Aetna of CA Gatekeeper $147.90
Rate for Payer: Aetna of CA Non-Gatekeeper $190.09
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $235.19
Rate for Payer: Alpha Care Medical Group Medi-Cal $152.19
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $207.53
Rate for Payer: Blue Shield of California Commercial $168.79
Rate for Payer: Blue Shield of California EPN $135.03
Rate for Payer: Cash Price $152.19
Rate for Payer: Cigna of CA HMO/PPO $179.85
Rate for Payer: Dignity Health Commercial/Exchange $235.19
Rate for Payer: Dignity Health Medi-Cal $235.19
Rate for Payer: Dignity Health Senior $235.19
Rate for Payer: EPIC Health Plan Commercial $177.09
Rate for Payer: Heritage Provider Network Commercial $171.28
Rate for Payer: Heritage Provider Network Senior $171.28
Rate for Payer: Kaiser Permanente of CA Commercial $131.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal $50.08
Rate for Payer: LLUH Dept of Risk Management WC $69.17
Rate for Payer: Molina Healthcare of CA Medi-Cal $193.69
Rate for Payer: Molina Healthcare of CA Medicare $193.69
Rate for Payer: Multiplan Commercial $207.53
Rate for Payer: TriValley Medical Group Commercial $110.68
Rate for Payer: TriValley Medical Group Senior $110.68
Rate for Payer: United Healthcare All Other HMO/non HMO $138.35
Rate for Payer: United Healthcare Navigate/Select/Select+ $138.35
Rate for Payer: Vantage Medical Group Commercial/Exchange $235.19
Rate for Payer: Vantage Medical Group Medi-Cal $235.19
Rate for Payer: Vantage Medical Group Senior $235.19
Service Code NDC 0069-0770-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $100.17
Max. Negotiated Rate $415.06
Rate for Payer: Adventist Health Commercial $110.68
Rate for Payer: Cash Price $304.37
Rate for Payer: EPIC Health Plan Commercial $298.84
Rate for Payer: Heritage Provider Network Commercial $374.66
Rate for Payer: Heritage Provider Network Senior $374.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $100.17
Rate for Payer: LLUH Dept of Risk Management WC $138.35
Rate for Payer: Multiplan Commercial $415.06
Service Code NDC 0069-0770-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $100.17
Max. Negotiated Rate $470.40
Rate for Payer: Adventist Health Commercial $110.68
Rate for Payer: Aetna of CA Gatekeeper $295.80
Rate for Payer: Aetna of CA Non-Gatekeeper $380.19
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $470.40
Rate for Payer: Alpha Care Medical Group Medi-Cal $304.38
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $415.06
Rate for Payer: Blue Shield of California Commercial $337.58
Rate for Payer: Blue Shield of California EPN $270.06
Rate for Payer: Cash Price $304.37
Rate for Payer: Cigna of CA HMO/PPO $359.72
Rate for Payer: Dignity Health Commercial/Exchange $470.40
Rate for Payer: Dignity Health Medi-Cal $470.40
Rate for Payer: Dignity Health Senior $470.40
Rate for Payer: EPIC Health Plan Commercial $354.18
Rate for Payer: Heritage Provider Network Commercial $342.56
Rate for Payer: Heritage Provider Network Senior $342.56
Rate for Payer: Kaiser Permanente of CA Commercial $263.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal $100.17
Rate for Payer: LLUH Dept of Risk Management WC $138.35
Rate for Payer: Molina Healthcare of CA Medi-Cal $387.39
Rate for Payer: Molina Healthcare of CA Medicare $387.39
Rate for Payer: Multiplan Commercial $415.06
Rate for Payer: TriValley Medical Group Commercial $221.36
Rate for Payer: TriValley Medical Group Senior $221.36
Rate for Payer: United Healthcare All Other HMO/non HMO $276.70
Rate for Payer: United Healthcare Navigate/Select/Select+ $276.70
Rate for Payer: Vantage Medical Group Commercial/Exchange $470.40
Rate for Payer: Vantage Medical Group Medi-Cal $470.40
Rate for Payer: Vantage Medical Group Senior $470.40
Service Code NDC 0069-0980-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $174.38
Max. Negotiated Rate $818.89
Rate for Payer: Adventist Health Commercial $192.68
Rate for Payer: Aetna of CA Gatekeeper $514.94
Rate for Payer: Aetna of CA Non-Gatekeeper $661.86
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $818.89
Rate for Payer: Alpha Care Medical Group Medi-Cal $529.87
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $722.55
Rate for Payer: Blue Shield of California Commercial $587.67
Rate for Payer: Blue Shield of California EPN $470.14
Rate for Payer: Cash Price $529.87
Rate for Payer: Cigna of CA HMO/PPO $626.21
Rate for Payer: Dignity Health Commercial/Exchange $818.89
Rate for Payer: Dignity Health Medi-Cal $818.89
Rate for Payer: Dignity Health Senior $818.89
Rate for Payer: EPIC Health Plan Commercial $616.58
Rate for Payer: Heritage Provider Network Commercial $596.34
Rate for Payer: Heritage Provider Network Senior $596.34
Rate for Payer: Kaiser Permanente of CA Commercial $459.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal $174.38
Rate for Payer: LLUH Dept of Risk Management WC $240.85
Rate for Payer: Molina Healthcare of CA Medi-Cal $674.38
Rate for Payer: Molina Healthcare of CA Medicare $674.38
Rate for Payer: Multiplan Commercial $722.55
Rate for Payer: TriValley Medical Group Commercial $385.36
Rate for Payer: TriValley Medical Group Senior $385.36
Rate for Payer: United Healthcare All Other HMO/non HMO $481.70
Rate for Payer: United Healthcare Navigate/Select/Select+ $481.70
Rate for Payer: Vantage Medical Group Commercial/Exchange $818.89
Rate for Payer: Vantage Medical Group Medi-Cal $818.89
Rate for Payer: Vantage Medical Group Senior $818.89
Service Code NDC 0069-0980-38
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $174.38
Max. Negotiated Rate $722.55
Rate for Payer: Adventist Health Commercial $192.68
Rate for Payer: Cash Price $529.87
Rate for Payer: EPIC Health Plan Commercial $520.24
Rate for Payer: Heritage Provider Network Commercial $652.22
Rate for Payer: Heritage Provider Network Senior $652.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal $174.38
Rate for Payer: LLUH Dept of Risk Management WC $240.85
Rate for Payer: Multiplan Commercial $722.55
Service Code NDC 0281020536
Hospital Charge Code 901700004
Hospital Revenue Code 250
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Cash Price $0.02
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 0281020536
Hospital Charge Code 901700004
Hospital Revenue Code 250
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 45802-390-00
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.51
Max. Negotiated Rate $2.38
Rate for Payer: Adventist Health Commercial $0.56
Rate for Payer: Aetna of CA Gatekeeper $1.50
Rate for Payer: Aetna of CA Non-Gatekeeper $1.92
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $2.38
Rate for Payer: Alpha Care Medical Group Medi-Cal $1.54
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $2.10
Rate for Payer: Blue Shield of California Commercial $1.71
Rate for Payer: Blue Shield of California EPN $1.37
Rate for Payer: Cash Price $1.54
Rate for Payer: Cigna of CA HMO/PPO $1.82
Rate for Payer: Dignity Health Commercial/Exchange $2.38
Rate for Payer: Dignity Health Medi-Cal $2.38
Rate for Payer: Dignity Health Senior $2.38
Rate for Payer: EPIC Health Plan Commercial $1.79
Rate for Payer: Heritage Provider Network Commercial $1.73
Rate for Payer: Heritage Provider Network Senior $1.73
Rate for Payer: Kaiser Permanente of CA Commercial $1.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.70
Rate for Payer: Molina Healthcare of CA Medi-Cal $1.96
Rate for Payer: Molina Healthcare of CA Medicare $1.96
Rate for Payer: Multiplan Commercial $2.10
Rate for Payer: TriValley Medical Group Commercial $1.12
Rate for Payer: TriValley Medical Group Senior $1.12
Rate for Payer: United Healthcare All Other HMO/non HMO $1.40
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.40
Rate for Payer: Vantage Medical Group Commercial/Exchange $2.38
Rate for Payer: Vantage Medical Group Medi-Cal $2.38
Rate for Payer: Vantage Medical Group Senior $2.38
Service Code NDC 45802-390-00
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.51
Max. Negotiated Rate $2.10
Rate for Payer: Adventist Health Commercial $0.56
Rate for Payer: Cash Price $1.54
Rate for Payer: EPIC Health Plan Commercial $1.51
Rate for Payer: Heritage Provider Network Commercial $1.90
Rate for Payer: Heritage Provider Network Senior $1.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.70
Rate for Payer: Multiplan Commercial $2.10
Service Code NDC 0168-0416-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.98
Max. Negotiated Rate $4.07
Rate for Payer: Adventist Health Commercial $1.08
Rate for Payer: Cash Price $2.98
Rate for Payer: EPIC Health Plan Commercial $2.93
Rate for Payer: Heritage Provider Network Commercial $3.67
Rate for Payer: Heritage Provider Network Senior $3.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.98
Rate for Payer: LLUH Dept of Risk Management WC $1.35
Rate for Payer: Multiplan Commercial $4.07
Service Code NDC 0168-0416-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.98
Max. Negotiated Rate $4.61
Rate for Payer: Adventist Health Commercial $1.08
Rate for Payer: Aetna of CA Gatekeeper $2.90
Rate for Payer: Aetna of CA Non-Gatekeeper $3.72
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $4.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.98
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $4.07
Rate for Payer: Blue Shield of California Commercial $3.31
Rate for Payer: Blue Shield of California EPN $2.64
Rate for Payer: Cash Price $2.98
Rate for Payer: Cigna of CA HMO/PPO $3.52
Rate for Payer: Dignity Health Commercial/Exchange $4.61
Rate for Payer: Dignity Health Medi-Cal $4.61
Rate for Payer: Dignity Health Senior $4.61
Rate for Payer: EPIC Health Plan Commercial $3.47
Rate for Payer: Heritage Provider Network Commercial $3.35
Rate for Payer: Heritage Provider Network Senior $3.35
Rate for Payer: Kaiser Permanente of CA Commercial $2.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.98
Rate for Payer: LLUH Dept of Risk Management WC $1.35
Rate for Payer: Molina Healthcare of CA Medi-Cal $3.79
Rate for Payer: Molina Healthcare of CA Medicare $3.79
Rate for Payer: Multiplan Commercial $4.07
Rate for Payer: TriValley Medical Group Commercial $2.17
Rate for Payer: TriValley Medical Group Senior $2.17
Rate for Payer: United Healthcare All Other HMO/non HMO $2.71
Rate for Payer: United Healthcare Navigate/Select/Select+ $2.71
Rate for Payer: Vantage Medical Group Commercial/Exchange $4.61
Rate for Payer: Vantage Medical Group Medi-Cal $4.61
Rate for Payer: Vantage Medical Group Senior $4.61
Service Code NDC 0168-0416-60
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.98
Max. Negotiated Rate $4.07
Rate for Payer: Adventist Health Commercial $1.08
Rate for Payer: Cash Price $2.98
Rate for Payer: EPIC Health Plan Commercial $2.93
Rate for Payer: Heritage Provider Network Commercial $3.67
Rate for Payer: Heritage Provider Network Senior $3.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.98
Rate for Payer: LLUH Dept of Risk Management WC $1.35
Rate for Payer: Multiplan Commercial $4.07
Service Code NDC 0168-0416-60
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.98
Max. Negotiated Rate $4.61
Rate for Payer: Adventist Health Commercial $1.08
Rate for Payer: Aetna of CA Gatekeeper $2.90
Rate for Payer: Aetna of CA Non-Gatekeeper $3.72
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $4.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.98
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $4.07
Rate for Payer: Blue Shield of California Commercial $3.31
Rate for Payer: Blue Shield of California EPN $2.64
Rate for Payer: Cash Price $2.98
Rate for Payer: Cigna of CA HMO/PPO $3.52
Rate for Payer: Dignity Health Commercial/Exchange $4.61
Rate for Payer: Dignity Health Medi-Cal $4.61
Rate for Payer: Dignity Health Senior $4.61
Rate for Payer: EPIC Health Plan Commercial $3.47
Rate for Payer: Heritage Provider Network Commercial $3.35
Rate for Payer: Heritage Provider Network Senior $3.35
Rate for Payer: Kaiser Permanente of CA Commercial $2.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.98
Rate for Payer: LLUH Dept of Risk Management WC $1.35
Rate for Payer: Molina Healthcare of CA Medi-Cal $3.79
Rate for Payer: Molina Healthcare of CA Medicare $3.79
Rate for Payer: Multiplan Commercial $4.07
Rate for Payer: TriValley Medical Group Commercial $2.17
Rate for Payer: TriValley Medical Group Senior $2.17
Rate for Payer: United Healthcare All Other HMO/non HMO $2.71
Rate for Payer: United Healthcare Navigate/Select/Select+ $2.71
Rate for Payer: Vantage Medical Group Commercial/Exchange $4.61
Rate for Payer: Vantage Medical Group Medi-Cal $4.61
Rate for Payer: Vantage Medical Group Senior $4.61
Service Code NDC 16729-422-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.40
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Aetna of CA Gatekeeper $2.14
Rate for Payer: Aetna of CA Non-Gatekeeper $2.75
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $3.40
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.20
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $3.00
Rate for Payer: Blue Shield of California Commercial $2.44
Rate for Payer: Blue Shield of California EPN $1.95
Rate for Payer: Cash Price $2.20
Rate for Payer: Cigna of CA HMO/PPO $2.60
Rate for Payer: Dignity Health Commercial/Exchange $3.40
Rate for Payer: Dignity Health Medi-Cal $3.40
Rate for Payer: Dignity Health Senior $3.40
Rate for Payer: EPIC Health Plan Commercial $2.56
Rate for Payer: Heritage Provider Network Commercial $2.48
Rate for Payer: Heritage Provider Network Senior $2.48
Rate for Payer: Kaiser Permanente of CA Commercial $1.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Molina Healthcare of CA Medi-Cal $2.80
Rate for Payer: Molina Healthcare of CA Medicare $2.80
Rate for Payer: Multiplan Commercial $3.00
Rate for Payer: TriValley Medical Group Commercial $1.60
Rate for Payer: TriValley Medical Group Senior $1.60
Rate for Payer: United Healthcare All Other HMO/non HMO $2.00
Rate for Payer: United Healthcare Navigate/Select/Select+ $2.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $3.40
Rate for Payer: Vantage Medical Group Medi-Cal $3.40
Rate for Payer: Vantage Medical Group Senior $3.40
Service Code NDC 16729-422-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.00
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Cash Price $2.20
Rate for Payer: EPIC Health Plan Commercial $2.16
Rate for Payer: Heritage Provider Network Commercial $2.71
Rate for Payer: Heritage Provider Network Senior $2.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Multiplan Commercial $3.00
Service Code NDC 68462-534-65
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.40
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Aetna of CA Gatekeeper $2.14
Rate for Payer: Aetna of CA Non-Gatekeeper $2.75
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $3.40
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.20
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $3.00
Rate for Payer: Blue Shield of California Commercial $2.44
Rate for Payer: Blue Shield of California EPN $1.95
Rate for Payer: Cash Price $2.20
Rate for Payer: Cigna of CA HMO/PPO $2.60
Rate for Payer: Dignity Health Commercial/Exchange $3.40
Rate for Payer: Dignity Health Medi-Cal $3.40
Rate for Payer: Dignity Health Senior $3.40
Rate for Payer: EPIC Health Plan Commercial $2.56
Rate for Payer: Heritage Provider Network Commercial $2.48
Rate for Payer: Heritage Provider Network Senior $2.48
Rate for Payer: Kaiser Permanente of CA Commercial $1.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Molina Healthcare of CA Medi-Cal $2.80
Rate for Payer: Molina Healthcare of CA Medicare $2.80
Rate for Payer: Multiplan Commercial $3.00
Rate for Payer: TriValley Medical Group Commercial $1.60
Rate for Payer: TriValley Medical Group Senior $1.60
Rate for Payer: United Healthcare All Other HMO/non HMO $2.00
Rate for Payer: United Healthcare Navigate/Select/Select+ $2.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $3.40
Rate for Payer: Vantage Medical Group Medi-Cal $3.40
Rate for Payer: Vantage Medical Group Senior $3.40
Service Code NDC 45802-700-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.40
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Aetna of CA Gatekeeper $2.14
Rate for Payer: Aetna of CA Non-Gatekeeper $2.75
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $3.40
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.20
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $3.00
Rate for Payer: Blue Shield of California Commercial $2.44
Rate for Payer: Blue Shield of California EPN $1.95
Rate for Payer: Cash Price $2.20
Rate for Payer: Cigna of CA HMO/PPO $2.60
Rate for Payer: Dignity Health Commercial/Exchange $3.40
Rate for Payer: Dignity Health Medi-Cal $3.40
Rate for Payer: Dignity Health Senior $3.40
Rate for Payer: EPIC Health Plan Commercial $2.56
Rate for Payer: Heritage Provider Network Commercial $2.48
Rate for Payer: Heritage Provider Network Senior $2.48
Rate for Payer: Kaiser Permanente of CA Commercial $1.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Molina Healthcare of CA Medi-Cal $2.80
Rate for Payer: Molina Healthcare of CA Medicare $2.80
Rate for Payer: Multiplan Commercial $3.00
Rate for Payer: TriValley Medical Group Commercial $1.60
Rate for Payer: TriValley Medical Group Senior $1.60
Rate for Payer: United Healthcare All Other HMO/non HMO $2.00
Rate for Payer: United Healthcare Navigate/Select/Select+ $2.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $3.40
Rate for Payer: Vantage Medical Group Medi-Cal $3.40
Rate for Payer: Vantage Medical Group Senior $3.40
Service Code NDC 68462-534-65
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.00
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Cash Price $2.20
Rate for Payer: EPIC Health Plan Commercial $2.16
Rate for Payer: Heritage Provider Network Commercial $2.71
Rate for Payer: Heritage Provider Network Senior $2.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Multiplan Commercial $3.00
Service Code NDC 45802-700-01
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.72
Max. Negotiated Rate $3.00
Rate for Payer: Adventist Health Commercial $0.80
Rate for Payer: Cash Price $2.20
Rate for Payer: EPIC Health Plan Commercial $2.16
Rate for Payer: Heritage Provider Network Commercial $2.71
Rate for Payer: Heritage Provider Network Senior $2.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.72
Rate for Payer: LLUH Dept of Risk Management WC $1.00
Rate for Payer: Multiplan Commercial $3.00
Service Code HCPCS J7507
Hospital Charge Code 901700025
Hospital Revenue Code 636
Min. Negotiated Rate $0.19
Max. Negotiated Rate $3.77
Rate for Payer: Adventist Health Commercial $0.89
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Adventist Health Commercial $0.08
Rate for Payer: Adventist Health Commercial $0.26
Rate for Payer: Aetna of CA Gatekeeper $0.71
Rate for Payer: Aetna of CA Gatekeeper $0.21
Rate for Payer: Aetna of CA Gatekeeper $2.37
Rate for Payer: Aetna of CA Gatekeeper $0.11
Rate for Payer: Aetna of CA Gatekeeper $0.30
Rate for Payer: Aetna of CA Non-Gatekeeper $3.05
Rate for Payer: Aetna of CA Non-Gatekeeper $0.27
Rate for Payer: Aetna of CA Non-Gatekeeper $0.14
Rate for Payer: Aetna of CA Non-Gatekeeper $0.91
Rate for Payer: Aetna of CA Non-Gatekeeper $0.38
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $1.12
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.48
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.17
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $3.77
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.34
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.22
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.73
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.11
Rate for Payer: Alpha Care Medical Group Medi-Cal $2.44
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.31
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.99
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $3.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.30
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.88
Rate for Payer: Blue Shield of California Commercial $0.74
Rate for Payer: Blue Shield of California Commercial $0.74
Rate for Payer: Blue Shield of California Commercial $0.74
Rate for Payer: Blue Shield of California Commercial $0.74
Rate for Payer: Blue Shield of California Commercial $0.74
Rate for Payer: Blue Shield of California EPN $0.74
Rate for Payer: Blue Shield of California EPN $0.74
Rate for Payer: Blue Shield of California EPN $0.74
Rate for Payer: Blue Shield of California EPN $0.74
Rate for Payer: Blue Shield of California EPN $0.74
Rate for Payer: Cash Price $0.11
Rate for Payer: Cash Price $0.11
Rate for Payer: Cash Price $0.22
Rate for Payer: Cash Price $0.22
Rate for Payer: Cash Price $0.73
Rate for Payer: Cash Price $2.44
Rate for Payer: Cash Price $2.44
Rate for Payer: Cash Price $0.73
Rate for Payer: Cash Price $0.31
Rate for Payer: Cash Price $0.31
Rate for Payer: Cigna of CA HMO/PPO $0.26
Rate for Payer: Cigna of CA HMO/PPO $0.18
Rate for Payer: Cigna of CA HMO/PPO $0.09
Rate for Payer: Cigna of CA HMO/PPO $0.61
Rate for Payer: Cigna of CA HMO/PPO $2.04
Rate for Payer: Dignity Health Commercial/Exchange $0.48
Rate for Payer: Dignity Health Commercial/Exchange $0.17
Rate for Payer: Dignity Health Commercial/Exchange $3.77
Rate for Payer: Dignity Health Commercial/Exchange $1.12
Rate for Payer: Dignity Health Commercial/Exchange $0.34
Rate for Payer: Dignity Health Medi-Cal $0.34
Rate for Payer: Dignity Health Medi-Cal $0.17
Rate for Payer: Dignity Health Medi-Cal $1.12
Rate for Payer: Dignity Health Medi-Cal $0.48
Rate for Payer: Dignity Health Medi-Cal $3.77
Rate for Payer: Dignity Health Senior $3.77
Rate for Payer: Dignity Health Senior $1.12
Rate for Payer: Dignity Health Senior $0.34
Rate for Payer: Dignity Health Senior $0.48
Rate for Payer: Dignity Health Senior $0.17
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Commercial $0.13
Rate for Payer: EPIC Health Plan Commercial $2.84
Rate for Payer: EPIC Health Plan Commercial $0.26
Rate for Payer: EPIC Health Plan Commercial $0.84
Rate for Payer: Heritage Provider Network Commercial $0.19
Rate for Payer: Heritage Provider Network Commercial $0.09
Rate for Payer: Heritage Provider Network Commercial $0.26
Rate for Payer: Heritage Provider Network Commercial $2.06
Rate for Payer: Heritage Provider Network Commercial $0.61
Rate for Payer: Heritage Provider Network Senior $0.19
Rate for Payer: Heritage Provider Network Senior $0.61
Rate for Payer: Heritage Provider Network Senior $0.09
Rate for Payer: Heritage Provider Network Senior $0.26
Rate for Payer: Heritage Provider Network Senior $2.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $0.19
Rate for Payer: Kaiser Permanente of CA Commercial $2.12
Rate for Payer: Kaiser Permanente of CA Commercial $0.63
Rate for Payer: Kaiser Permanente of CA Commercial $0.27
Rate for Payer: Kaiser Permanente of CA Commercial $0.10
Rate for Payer: Kaiser Permanente of CA Commercial $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
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: LLUH Dept of Risk Management WC $0.05
Rate for Payer: LLUH Dept of Risk Management WC $1.11
Rate for Payer: LLUH Dept of Risk Management WC $0.33
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Molina Healthcare of CA Medi-Cal $3.11
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.39
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.28
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.14
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.92
Rate for Payer: Molina Healthcare of CA Medicare $3.11
Rate for Payer: Molina Healthcare of CA Medicare $0.28
Rate for Payer: Molina Healthcare of CA Medicare $0.39
Rate for Payer: Molina Healthcare of CA Medicare $0.14
Rate for Payer: Molina Healthcare of CA Medicare $0.92
Rate for Payer: Multiplan Commercial $0.15
Rate for Payer: Multiplan Commercial $0.42
Rate for Payer: Multiplan Commercial $0.99
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Multiplan Commercial $3.33
Rate for Payer: TriValley Medical Group Commercial $0.53
Rate for Payer: TriValley Medical Group Commercial $0.22
Rate for Payer: TriValley Medical Group Commercial $1.78
Rate for Payer: TriValley Medical Group Commercial $0.08
Rate for Payer: TriValley Medical Group Commercial $0.16
Rate for Payer: TriValley Medical Group Senior $0.16
Rate for Payer: TriValley Medical Group Senior $1.78
Rate for Payer: TriValley Medical Group Senior $0.53
Rate for Payer: TriValley Medical Group Senior $0.22
Rate for Payer: TriValley Medical Group Senior $0.08
Rate for Payer: United Healthcare All Other HMO/non HMO $0.20
Rate for Payer: United Healthcare All Other HMO/non HMO $0.07
Rate for Payer: United Healthcare All Other HMO/non HMO $0.14
Rate for Payer: United Healthcare All Other HMO/non HMO $1.60
Rate for Payer: United Healthcare All Other HMO/non HMO $0.48
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.13
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.44
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.19
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.47
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.07
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.34
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.17
Rate for Payer: Vantage Medical Group Commercial/Exchange $1.12
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.48
Rate for Payer: Vantage Medical Group Commercial/Exchange $3.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.48
Rate for Payer: Vantage Medical Group Medi-Cal $0.17
Rate for Payer: Vantage Medical Group Medi-Cal $1.12
Rate for Payer: Vantage Medical Group Medi-Cal $3.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.34
Rate for Payer: Vantage Medical Group Senior $0.17
Rate for Payer: Vantage Medical Group Senior $1.12
Rate for Payer: Vantage Medical Group Senior $0.48
Rate for Payer: Vantage Medical Group Senior $3.77
Rate for Payer: Vantage Medical Group Senior $0.34
Service Code HCPCS J7507
Hospital Charge Code 901700025
Hospital Revenue Code 636
Min. Negotiated Rate $0.80
Max. Negotiated Rate $3.33
Rate for Payer: Adventist Health Commercial $0.89
Rate for Payer: Adventist Health Commercial $0.08
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Adventist Health Commercial $0.26
Rate for Payer: Cash Price $0.11
Rate for Payer: Cash Price $0.73
Rate for Payer: Cash Price $0.22
Rate for Payer: Cash Price $0.31
Rate for Payer: Cash Price $2.44
Rate for Payer: Cigna of CA HMO/PPO $0.26
Rate for Payer: Cigna of CA HMO/PPO $2.04
Rate for Payer: Cigna of CA HMO/PPO $0.18
Rate for Payer: Cigna of CA HMO/PPO $0.09
Rate for Payer: Cigna of CA HMO/PPO $0.61
Rate for Payer: EPIC Health Plan Commercial $0.71
Rate for Payer: EPIC Health Plan Commercial $0.30
Rate for Payer: EPIC Health Plan Commercial $2.40
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: Heritage Provider Network Commercial $2.06
Rate for Payer: Heritage Provider Network Commercial $0.26
Rate for Payer: Heritage Provider Network Commercial $0.61
Rate for Payer: Heritage Provider Network Commercial $0.19
Rate for Payer: Heritage Provider Network Commercial $0.09
Rate for Payer: Heritage Provider Network Senior $0.26
Rate for Payer: Heritage Provider Network Senior $0.09
Rate for Payer: Heritage Provider Network Senior $0.19
Rate for Payer: Heritage Provider Network Senior $0.61
Rate for Payer: Heritage Provider Network Senior $2.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.24
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: LLUH Dept of Risk Management WC $1.11
Rate for Payer: LLUH Dept of Risk Management WC $0.33
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Multiplan Commercial $0.42
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Multiplan Commercial $0.99
Rate for Payer: Multiplan Commercial $0.15
Rate for Payer: Multiplan Commercial $3.33
Rate for Payer: United Healthcare All Other HMO/non HMO $0.07
Rate for Payer: United Healthcare All Other HMO/non HMO $0.48
Rate for Payer: United Healthcare All Other HMO/non HMO $1.60
Rate for Payer: United Healthcare All Other HMO/non HMO $0.14
Rate for Payer: United Healthcare All Other HMO/non HMO $0.20
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.44
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.19
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.13
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.07
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.47