|
TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
|
Facility
IP
|
$16.80
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
NDG223020
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.54
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.37
|
| Rate for Payer: Heritage Provider Network Senior |
$11.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Multiplan Commercial |
$12.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.61
|
|
|
TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
|
Facility
OP
|
$16.80
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
NDG223020
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$14.28 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Aetna of CA Gatekeeper |
$8.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$10.43
|
| Rate for Payer: Blue Shield of California EPN |
$9.86
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.28
|
| Rate for Payer: Dignity Health Senior |
$14.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.78
|
| Rate for Payer: Heritage Provider Network Senior |
$7.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Multiplan Commercial |
$12.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.28
|
| Rate for Payer: Vantage Medical Group Senior |
$14.28
|
|
|
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE [88317]
|
Facility
IP
|
$177.84
|
|
|
Service Code
|
CPT Q9968
|
| Hospital Charge Code |
1740332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.19 |
| Max. Negotiated Rate |
$133.38 |
| Rate for Payer: Adventist Health Commercial |
$35.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$122.18
|
| Rate for Payer: Cash Price |
$80.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$81.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$120.40
|
| Rate for Payer: Heritage Provider Network Senior |
$120.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.46
|
| Rate for Payer: Multiplan Commercial |
$133.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$64.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$59.42
|
|
|
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE [88317]
|
Facility
OP
|
$177.84
|
|
|
Service Code
|
CPT Q9968
|
| Hospital Charge Code |
1740332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$133.38 |
| Rate for Payer: Adventist Health Commercial |
$35.57
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$122.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.55
|
| Rate for Payer: Blue Shield of California Commercial |
$110.44
|
| Rate for Payer: Blue Shield of California EPN |
$104.39
|
| Rate for Payer: Cash Price |
$80.03
|
| Rate for Payer: Cash Price |
$80.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$81.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.74
|
| Rate for Payer: Dignity Health Senior |
$8.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.82
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$82.34
|
| Rate for Payer: Heritage Provider Network Senior |
$82.34
|
| Rate for Payer: Humana Medicare |
$7.95
|
| Rate for Payer: IEHP Medi-Cal |
$29.08
|
| Rate for Payer: IEHP Medicare Advantage |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.02
|
| Rate for Payer: Multiplan Commercial |
$133.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.74
|
| Rate for Payer: TriValley Medical Group Senior |
$7.95
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$64.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$59.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.74
|
| Rate for Payer: Vantage Medical Group Senior |
$7.95
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
IP
|
$92.05
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
NDG8259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.66 |
| Max. Negotiated Rate |
$69.04 |
| Rate for Payer: Adventist Health Commercial |
$18.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$63.24
|
| Rate for Payer: Cash Price |
$41.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.32
|
| Rate for Payer: Heritage Provider Network Senior |
$62.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.01
|
| Rate for Payer: Multiplan Commercial |
$69.04
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
OP
|
$113.05
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
NDG2224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$84.79 |
| Rate for Payer: Adventist Health Commercial |
$22.61
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$77.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.56
|
| Rate for Payer: Blue Shield of California Commercial |
$70.20
|
| Rate for Payer: Blue Shield of California EPN |
$66.36
|
| Rate for Payer: Cash Price |
$50.87
|
| Rate for Payer: Cash Price |
$50.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$73.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$69.98
|
| Rate for Payer: Heritage Provider Network Senior |
$69.98
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: IEHP Medi-Cal |
$5.24
|
| Rate for Payer: IEHP Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$84.79
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
IP
|
$113.05
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
NDG2224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$84.79 |
| Rate for Payer: Adventist Health Commercial |
$22.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$77.67
|
| Rate for Payer: Cash Price |
$50.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$76.53
|
| Rate for Payer: Heritage Provider Network Senior |
$76.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.26
|
| Rate for Payer: Multiplan Commercial |
$84.79
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
OP
|
$118.70
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
1720235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$89.02 |
| Rate for Payer: Adventist Health Commercial |
$23.74
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$81.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.56
|
| Rate for Payer: Blue Shield of California Commercial |
$73.71
|
| Rate for Payer: Blue Shield of California EPN |
$69.68
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cigna of CA HMO/PPO |
$77.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.16
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.48
|
| Rate for Payer: Heritage Provider Network Senior |
$73.48
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: IEHP Medi-Cal |
$5.24
|
| Rate for Payer: IEHP Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$89.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
OP
|
$92.05
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
NDG8259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$70.68 |
| Rate for Payer: Adventist Health Commercial |
$18.41
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$63.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.56
|
| Rate for Payer: Blue Shield of California Commercial |
$57.16
|
| Rate for Payer: Blue Shield of California EPN |
$54.03
|
| Rate for Payer: Cash Price |
$41.42
|
| Rate for Payer: Cash Price |
$41.42
|
| Rate for Payer: Cigna of CA HMO/PPO |
$59.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.83
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$56.98
|
| Rate for Payer: Heritage Provider Network Senior |
$56.98
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: IEHP Medi-Cal |
$5.24
|
| Rate for Payer: IEHP Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$69.04
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]
|
Facility
IP
|
$118.70
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
1720235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$89.02 |
| Rate for Payer: Adventist Health Commercial |
$23.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$81.55
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$80.36
|
| Rate for Payer: Heritage Provider Network Senior |
$80.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.68
|
| Rate for Payer: Multiplan Commercial |
$89.02
|
|
|
TUCATINIB 150 MG TABLET [227737]
|
Facility
OP
|
$235.14
|
|
|
Service Code
|
NDC 51144-002-12
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$42.56 |
| Max. Negotiated Rate |
$199.87 |
| Rate for Payer: Adventist Health Commercial |
$47.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$125.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$199.87
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$129.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$176.36
|
| Rate for Payer: Blue Shield of California Commercial |
$146.02
|
| Rate for Payer: Blue Shield of California EPN |
$138.03
|
| Rate for Payer: Cash Price |
$105.81
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.87
|
| Rate for Payer: Dignity Health Senior |
$199.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$145.55
|
| Rate for Payer: Heritage Provider Network Senior |
$145.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$113.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.78
|
| Rate for Payer: Multiplan Commercial |
$176.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.87
|
| Rate for Payer: Vantage Medical Group Senior |
$199.87
|
|
|
TUCATINIB 150 MG TABLET [227737]
|
Facility
IP
|
$235.14
|
|
|
Service Code
|
NDC 51144-002-12
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$42.56 |
| Max. Negotiated Rate |
$176.36 |
| Rate for Payer: Adventist Health Commercial |
$47.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.54
|
| Rate for Payer: Cash Price |
$105.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.19
|
| Rate for Payer: Heritage Provider Network Senior |
$159.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.78
|
| Rate for Payer: Multiplan Commercial |
$176.36
|
|
|
TUCATINIB 50 MG TABLET [227736]
|
Facility
IP
|
$116.94
|
|
|
Service Code
|
NDC 51144-001-60
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$21.17 |
| Max. Negotiated Rate |
$87.70 |
| Rate for Payer: Adventist Health Commercial |
$23.39
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$80.34
|
| Rate for Payer: Cash Price |
$52.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$79.17
|
| Rate for Payer: Heritage Provider Network Senior |
$79.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.24
|
| Rate for Payer: Multiplan Commercial |
$87.70
|
|
|
TUCATINIB 50 MG TABLET [227736]
|
Facility
OP
|
$116.94
|
|
|
Service Code
|
NDC 51144-001-60
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$21.17 |
| Max. Negotiated Rate |
$99.40 |
| Rate for Payer: Adventist Health Commercial |
$23.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$62.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$80.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$99.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$64.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$87.70
|
| Rate for Payer: Blue Shield of California Commercial |
$72.62
|
| Rate for Payer: Blue Shield of California EPN |
$68.64
|
| Rate for Payer: Cash Price |
$52.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$76.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.40
|
| Rate for Payer: Dignity Health Senior |
$99.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$72.39
|
| Rate for Payer: Heritage Provider Network Senior |
$72.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$56.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.24
|
| Rate for Payer: Multiplan Commercial |
$87.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.40
|
| Rate for Payer: Vantage Medical Group Senior |
$99.40
|
|
|
Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch
|
Facility
OP
|
$4,547.00
|
|
|
Service Code
|
CPT 69610
|
| Min. Negotiated Rate |
$222.44 |
| Max. Negotiated Rate |
$4,547.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: Dignity Health Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,905.44
|
| Rate for Payer: Humana Medicare |
$1,905.44
|
| Rate for Payer: IEHP Medi-Cal |
$222.44
|
| Rate for Payer: IEHP Medicare Advantage |
$1,905.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,620.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,248.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,400.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,400.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,095.98
|
| Rate for Payer: TriValley Medical Group Senior |
$1,905.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69637
|
| Min. Negotiated Rate |
$1,742.36 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$1,742.36
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69646
|
| Min. Negotiated Rate |
$1,578.58 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$1,578.58
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69645
|
| Min. Negotiated Rate |
$293.87 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$293.87
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69643
|
| Min. Negotiated Rate |
$278.77 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$278.77
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69642
|
| Min. Negotiated Rate |
$1,507.15 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$1,507.15
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69641
|
| Min. Negotiated Rate |
$278.77 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$278.77
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69633
|
| Min. Negotiated Rate |
$255.54 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$5,088.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$255.54
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69632
|
| Min. Negotiated Rate |
$1,277.73 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$5,088.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$1,277.73
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction
|
Facility
OP
|
$13,902.11
|
|
|
Service Code
|
CPT 69631
|
| Min. Negotiated Rate |
$255.54 |
| Max. Negotiated Rate |
$13,902.11 |
| Rate for Payer: Aetna of CA Gatekeeper |
$5,088.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,054.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: Dignity Health Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,316.90
|
| Rate for Payer: Humana Medicare |
$7,316.90
|
| Rate for Payer: IEHP Medi-Cal |
$255.54
|
| Rate for Payer: IEHP Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,902.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,633.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,219.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$8,048.59
|
| Rate for Payer: TriValley Medical Group Senior |
$7,316.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
|
Facility
OP
|
$4,547.00
|
|
|
Service Code
|
CPT 69436
|
| Min. Negotiated Rate |
$188.18 |
| Max. Negotiated Rate |
$4,547.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: Dignity Health Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,905.44
|
| Rate for Payer: Humana Medicare |
$1,905.44
|
| Rate for Payer: IEHP Medi-Cal |
$188.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,905.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,620.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,248.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,400.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,400.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,095.98
|
| Rate for Payer: TriValley Medical Group Senior |
$1,905.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
