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Service Code NDC 59746-113-06
Hospital Charge Code 1710782
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.36
Rate for Payer: Adventist Health Commercial $0.08
Rate for Payer: Aetna of CA Gatekeeper $0.22
Rate for Payer: Aetna of CA Non-Gatekeeper $0.29
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.36
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.32
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.25
Rate for Payer: Cash Price $0.19
Rate for Payer: Cigna of CA HMO/PPO $0.27
Rate for Payer: Dignity Health Commercial/Exchange $0.36
Rate for Payer: Dignity Health Medi-Cal $0.36
Rate for Payer: Dignity Health Senior $0.36
Rate for Payer: EPIC Health Plan Commercial $0.27
Rate for Payer: Heritage Provider Network Commercial $0.26
Rate for Payer: Heritage Provider Network Senior $0.26
Rate for Payer: Kaiser Permanente of CA Commercial $0.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.32
Rate for Payer: Vantage Medical Group Medi-Cal $0.36
Rate for Payer: Vantage Medical Group Senior $0.36
Service Code NDC 59746-113-06
Hospital Charge Code 1710782
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.32
Rate for Payer: Adventist Health Commercial $0.08
Rate for Payer: Aetna of CA Non-Gatekeeper $0.29
Rate for Payer: Cash Price $0.19
Rate for Payer: EPIC Health Plan Commercial $0.23
Rate for Payer: Heritage Provider Network Commercial $0.28
Rate for Payer: Heritage Provider Network Senior $0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.32
Service Code CPT J2675
Hospital Charge Code 1721037
Hospital Revenue Code 636
Min. Negotiated Rate $0.65
Max. Negotiated Rate $8.38
Rate for Payer: Adventist Health Commercial $0.72
Rate for Payer: Aetna of CA Gatekeeper $2.24
Rate for Payer: Aetna of CA Non-Gatekeeper $2.47
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.97
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $6.93
Rate for Payer: Blue Shield of California Commercial $3.19
Rate for Payer: Blue Shield of California EPN $3.19
Rate for Payer: Cash Price $1.62
Rate for Payer: Cash Price $1.62
Rate for Payer: Cigna of CA HMO/PPO $1.65
Rate for Payer: Dignity Health Commercial/Exchange $3.05
Rate for Payer: Dignity Health Medi-Cal $3.05
Rate for Payer: Dignity Health Senior $3.05
Rate for Payer: EPIC Health Plan Commercial $2.30
Rate for Payer: Heritage Provider Network Commercial $1.66
Rate for Payer: Heritage Provider Network Senior $1.66
Rate for Payer: IEHP Medi-Cal $8.38
Rate for Payer: Kaiser Permanente of CA Commercial $1.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.65
Rate for Payer: LLUH Dept of Risk Management WC $0.90
Rate for Payer: Multiplan Commercial $2.69
Rate for Payer: United Healthcare All Other HMO/non HMO $1.31
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.20
Rate for Payer: Vantage Medical Group Medi-Cal $3.05
Rate for Payer: Vantage Medical Group Senior $3.05
Service Code CPT J2675
Hospital Charge Code 1721037
Hospital Revenue Code 636
Min. Negotiated Rate $0.65
Max. Negotiated Rate $2.69
Rate for Payer: Adventist Health Commercial $0.72
Rate for Payer: Aetna of CA Non-Gatekeeper $2.47
Rate for Payer: Cash Price $1.62
Rate for Payer: Cigna of CA HMO/PPO $1.65
Rate for Payer: EPIC Health Plan Commercial $1.94
Rate for Payer: Heritage Provider Network Commercial $2.43
Rate for Payer: Heritage Provider Network Senior $2.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.65
Rate for Payer: LLUH Dept of Risk Management WC $0.90
Rate for Payer: Multiplan Commercial $2.69
Rate for Payer: United Healthcare All Other HMO/non HMO $1.31
Rate for Payer: United Healthcare Navigate/Select/Select+ $1.20
Service Code NDC 59651-152-01
Hospital Charge Code 1711912
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.18
Rate for Payer: Adventist Health Commercial $0.05
Rate for Payer: Aetna of CA Non-Gatekeeper $0.16
Rate for Payer: Cash Price $0.11
Rate for Payer: EPIC Health Plan Commercial $0.13
Rate for Payer: Heritage Provider Network Commercial $0.16
Rate for Payer: Heritage Provider Network Senior $0.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Service Code NDC 17478-766-10
Hospital Charge Code 1711912
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: AlphaCare Medical Group Commercial/Exchange $0.61
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.54
Rate for Payer: Blue Shield of California Commercial $0.45
Rate for Payer: Blue Shield of California EPN $0.42
Rate for Payer: Cash Price $0.32
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 $0.35
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
Rate for Payer: Vantage Medical Group Medi-Cal $0.61
Rate for Payer: Vantage Medical Group Senior $0.61
Service Code NDC 59651-152-01
Hospital Charge Code 1711912
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.20
Rate for Payer: Adventist Health Commercial $0.05
Rate for Payer: Aetna of CA Gatekeeper $0.13
Rate for Payer: Aetna of CA Non-Gatekeeper $0.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.18
Rate for Payer: Blue Shield of California Commercial $0.15
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.11
Rate for Payer: Cigna of CA HMO/PPO $0.16
Rate for Payer: Dignity Health Commercial/Exchange $0.20
Rate for Payer: Dignity Health Medi-Cal $0.20
Rate for Payer: Dignity Health Senior $0.20
Rate for Payer: EPIC Health Plan Commercial $0.15
Rate for Payer: Heritage Provider Network Commercial $0.15
Rate for Payer: Heritage Provider Network Senior $0.15
Rate for Payer: Kaiser Permanente of CA Commercial $0.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Vantage Medical Group Medi-Cal $0.20
Rate for Payer: Vantage Medical Group Senior $0.20
Service Code NDC 43598-349-01
Hospital Charge Code 1711912
Hospital Revenue Code 259
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.98
Rate for Payer: Adventist Health Commercial $0.26
Rate for Payer: Aetna of CA Non-Gatekeeper $0.90
Rate for Payer: Cash Price $0.59
Rate for Payer: EPIC Health Plan Commercial $0.71
Rate for Payer: Heritage Provider Network Commercial $0.89
Rate for Payer: Heritage Provider Network Senior $0.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.24
Rate for Payer: LLUH Dept of Risk Management WC $0.33
Rate for Payer: Multiplan Commercial $0.98
Service Code NDC 17478-766-10
Hospital Charge Code 1711912
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: Aetna of CA Non-Gatekeeper $0.49
Rate for Payer: Cash Price $0.32
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 43598-349-01
Hospital Charge Code 1711912
Hospital Revenue Code 259
Min. Negotiated Rate $0.24
Max. Negotiated Rate $1.11
Rate for Payer: Adventist Health Commercial $0.26
Rate for Payer: Aetna of CA Gatekeeper $0.70
Rate for Payer: Aetna of CA Non-Gatekeeper $0.90
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.11
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.72
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.98
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.77
Rate for Payer: Cash Price $0.59
Rate for Payer: Cigna of CA HMO/PPO $0.85
Rate for Payer: Dignity Health Commercial/Exchange $1.11
Rate for Payer: Dignity Health Medi-Cal $1.11
Rate for Payer: Dignity Health Senior $1.11
Rate for Payer: EPIC Health Plan Commercial $0.84
Rate for Payer: Heritage Provider Network Commercial $0.81
Rate for Payer: Heritage Provider Network Senior $0.81
Rate for Payer: Kaiser Permanente of CA Commercial $0.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.24
Rate for Payer: LLUH Dept of Risk Management WC $0.33
Rate for Payer: Multiplan Commercial $0.98
Rate for Payer: Vantage Medical Group Medi-Cal $1.11
Rate for Payer: Vantage Medical Group Senior $1.11
Service Code NDC 51672-5296-1
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $9.94
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Gatekeeper $6.25
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $9.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $6.44
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.78
Rate for Payer: Blue Shield of California Commercial $7.27
Rate for Payer: Blue Shield of California EPN $6.87
Rate for Payer: Cash Price $5.27
Rate for Payer: Cigna of CA HMO/PPO $7.60
Rate for Payer: Dignity Health Commercial/Exchange $9.94
Rate for Payer: Dignity Health Medi-Cal $9.94
Rate for Payer: Dignity Health Senior $9.94
Rate for Payer: EPIC Health Plan Commercial $7.49
Rate for Payer: Heritage Provider Network Commercial $7.24
Rate for Payer: Heritage Provider Network Senior $7.24
Rate for Payer: Kaiser Permanente of CA Commercial $5.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Rate for Payer: Vantage Medical Group Medi-Cal $9.94
Rate for Payer: Vantage Medical Group Senior $9.94
Service Code NDC 51672-5296-5
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $9.94
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Gatekeeper $6.25
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $9.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $6.44
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.78
Rate for Payer: Blue Shield of California Commercial $7.27
Rate for Payer: Blue Shield of California EPN $6.87
Rate for Payer: Cash Price $5.27
Rate for Payer: Cigna of CA HMO/PPO $7.60
Rate for Payer: Dignity Health Commercial/Exchange $9.94
Rate for Payer: Dignity Health Medi-Cal $9.94
Rate for Payer: Dignity Health Senior $9.94
Rate for Payer: EPIC Health Plan Commercial $7.49
Rate for Payer: Heritage Provider Network Commercial $7.24
Rate for Payer: Heritage Provider Network Senior $7.24
Rate for Payer: Kaiser Permanente of CA Commercial $5.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Rate for Payer: Vantage Medical Group Medi-Cal $9.94
Rate for Payer: Vantage Medical Group Senior $9.94
Service Code NDC 0713-0536-12
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $9.94
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Gatekeeper $6.25
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $9.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $6.44
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.78
Rate for Payer: Blue Shield of California Commercial $7.27
Rate for Payer: Blue Shield of California EPN $6.87
Rate for Payer: Cash Price $5.27
Rate for Payer: Cigna of CA HMO/PPO $7.60
Rate for Payer: Dignity Health Commercial/Exchange $9.94
Rate for Payer: Dignity Health Medi-Cal $9.94
Rate for Payer: Dignity Health Senior $9.94
Rate for Payer: EPIC Health Plan Commercial $7.49
Rate for Payer: Heritage Provider Network Commercial $7.24
Rate for Payer: Heritage Provider Network Senior $7.24
Rate for Payer: Kaiser Permanente of CA Commercial $5.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Rate for Payer: Vantage Medical Group Medi-Cal $9.94
Rate for Payer: Vantage Medical Group Senior $9.94
Service Code NDC 0713-0536-06
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $9.94
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Gatekeeper $6.25
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $9.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $6.44
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.78
Rate for Payer: Blue Shield of California Commercial $7.27
Rate for Payer: Blue Shield of California EPN $6.87
Rate for Payer: Cash Price $5.27
Rate for Payer: Cigna of CA HMO/PPO $7.60
Rate for Payer: Dignity Health Commercial/Exchange $9.94
Rate for Payer: Dignity Health Medi-Cal $9.94
Rate for Payer: Dignity Health Senior $9.94
Rate for Payer: EPIC Health Plan Commercial $7.49
Rate for Payer: Heritage Provider Network Commercial $7.24
Rate for Payer: Heritage Provider Network Senior $7.24
Rate for Payer: Kaiser Permanente of CA Commercial $5.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Rate for Payer: Vantage Medical Group Medi-Cal $9.94
Rate for Payer: Vantage Medical Group Senior $9.94
Service Code NDC 0713-0536-06
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $8.78
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: Cash Price $5.27
Rate for Payer: EPIC Health Plan Commercial $6.32
Rate for Payer: Heritage Provider Network Commercial $7.92
Rate for Payer: Heritage Provider Network Senior $7.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Service Code NDC 0713-0536-12
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $8.78
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: Cash Price $5.27
Rate for Payer: EPIC Health Plan Commercial $6.32
Rate for Payer: Heritage Provider Network Commercial $7.92
Rate for Payer: Heritage Provider Network Senior $7.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Service Code NDC 51672-5296-5
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $8.78
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: Cash Price $5.27
Rate for Payer: EPIC Health Plan Commercial $6.32
Rate for Payer: Heritage Provider Network Commercial $7.92
Rate for Payer: Heritage Provider Network Senior $7.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Service Code NDC 51672-5296-1
Hospital Charge Code 1748042
Hospital Revenue Code 259
Min. Negotiated Rate $2.12
Max. Negotiated Rate $8.78
Rate for Payer: Adventist Health Commercial $2.34
Rate for Payer: Aetna of CA Non-Gatekeeper $8.04
Rate for Payer: Cash Price $5.27
Rate for Payer: EPIC Health Plan Commercial $6.32
Rate for Payer: Heritage Provider Network Commercial $7.92
Rate for Payer: Heritage Provider Network Senior $7.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.12
Rate for Payer: LLUH Dept of Risk Management WC $2.92
Rate for Payer: Multiplan Commercial $8.78
Service Code NDC 68084-154-11
Hospital Charge Code 1710621
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.46
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Aetna of CA Gatekeeper $0.29
Rate for Payer: Aetna of CA Non-Gatekeeper $0.37
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.46
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.30
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.41
Rate for Payer: Blue Shield of California Commercial $0.34
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.24
Rate for Payer: Cigna of CA HMO/PPO $0.35
Rate for Payer: Dignity Health Commercial/Exchange $0.46
Rate for Payer: Dignity Health Medi-Cal $0.46
Rate for Payer: Dignity Health Senior $0.46
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Heritage Provider Network Commercial $0.33
Rate for Payer: Heritage Provider Network Senior $0.33
Rate for Payer: Kaiser Permanente of CA Commercial $0.26
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 $0.41
Rate for Payer: Vantage Medical Group Medi-Cal $0.46
Rate for Payer: Vantage Medical Group Senior $0.46
Service Code NDC 68084-154-11
Hospital Charge Code 1710621
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.41
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Aetna of CA Non-Gatekeeper $0.37
Rate for Payer: Cash Price $0.24
Rate for Payer: EPIC Health Plan Commercial $0.29
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 Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.41
Service Code NDC 68001-161-00
Hospital Charge Code 1710621
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: AlphaCare Medical Group Commercial/Exchange $0.12
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.08
Rate for Payer: AlphaCare 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 $0.08
Rate for Payer: Cash Price $0.06
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: Multiplan Commercial $0.11
Rate for Payer: Vantage Medical Group Medi-Cal $0.12
Rate for Payer: Vantage Medical Group Senior $0.12
Service Code NDC 10702-002-01
Hospital Charge Code 1710621
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.04
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.06
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.05
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.03
Rate for Payer: Cigna of CA HMO/PPO $0.05
Rate for Payer: Dignity Health Commercial/Exchange $0.06
Rate for Payer: Dignity Health Medi-Cal $0.06
Rate for Payer: Dignity Health Senior $0.06
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Heritage Provider Network Commercial $0.04
Rate for Payer: Heritage Provider Network Senior $0.04
Rate for Payer: Kaiser Permanente of CA Commercial $0.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Vantage Medical Group Medi-Cal $0.06
Rate for Payer: Vantage Medical Group Senior $0.06
Service Code NDC 68001-161-00
Hospital Charge Code 1710621
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: Aetna of CA Non-Gatekeeper $0.10
Rate for Payer: Cash Price $0.06
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 10702-002-01
Hospital Charge Code 1710621
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: Cash Price $0.03
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Heritage Provider Network Commercial $0.05
Rate for Payer: Heritage Provider Network Senior $0.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Service Code CPT J2550
Hospital Charge Code 1720455
Hospital Revenue Code 636
Min. Negotiated Rate $0.43
Max. Negotiated Rate $1.80
Rate for Payer: Adventist Health Commercial $0.48
Rate for Payer: Adventist Health Commercial $0.44
Rate for Payer: Aetna of CA Non-Gatekeeper $1.65
Rate for Payer: Aetna of CA Non-Gatekeeper $1.53
Rate for Payer: Cash Price $1.00
Rate for Payer: Cash Price $1.08
Rate for Payer: Cigna of CA HMO/PPO $1.02
Rate for Payer: Cigna of CA HMO/PPO $1.10
Rate for Payer: EPIC Health Plan Commercial $1.30
Rate for Payer: EPIC Health Plan Commercial $1.20
Rate for Payer: Heritage Provider Network Commercial $1.50
Rate for Payer: Heritage Provider Network Commercial $1.62
Rate for Payer: Heritage Provider Network Senior $1.62
Rate for Payer: Heritage Provider Network Senior $1.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.40
Rate for Payer: LLUH Dept of Risk Management WC $0.56
Rate for Payer: LLUH Dept of Risk Management WC $0.60
Rate for Payer: Multiplan Commercial $1.80
Rate for Payer: Multiplan Commercial $1.66
Rate for Payer: United Healthcare All Other HMO/non HMO $0.81
Rate for Payer: United Healthcare All Other HMO/non HMO $0.88
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.80
Rate for Payer: United Healthcare Navigate/Select/Select+ $0.74