Loma Linda University Medical Center

All Charges

Charge

Type

Price

VAGINAL DELIVERY

Facility IP

$3,541.83

Service Code	APR-DRG 5602
Min. Negotiated Rate	$3,541.83
Max. Negotiated Rate	$3,541.83
Rate for Payer: IEHP Medi-Cal	$3,541.83

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$3,576.65

Service Code	APR-DRG 5421
Min. Negotiated Rate	$3,576.65
Max. Negotiated Rate	$3,576.65
Rate for Payer: IEHP Medi-Cal	$3,576.65

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$4,068.13

Service Code	APR-DRG 5422
Min. Negotiated Rate	$4,068.13
Max. Negotiated Rate	$4,068.13
Rate for Payer: IEHP Medi-Cal	$4,068.13

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$15,158.34

Service Code	APR-DRG 5424
Min. Negotiated Rate	$15,158.34
Max. Negotiated Rate	$15,158.34
Rate for Payer: IEHP Medi-Cal	$15,158.34

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$6,001.21

Service Code	APR-DRG 5423
Min. Negotiated Rate	$6,001.21
Max. Negotiated Rate	$6,001.21
Rate for Payer: IEHP Medi-Cal	$6,001.21

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$5,680.85

Service Code	APR-DRG 5412
Min. Negotiated Rate	$5,680.85
Max. Negotiated Rate	$5,680.85
Rate for Payer: IEHP Medi-Cal	$5,680.85

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$10,343.04

Service Code	APR-DRG 5414
Min. Negotiated Rate	$10,343.04
Max. Negotiated Rate	$10,343.04
Rate for Payer: IEHP Medi-Cal	$10,343.04

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$5,450.04

Service Code	APR-DRG 5411
Min. Negotiated Rate	$5,450.04
Max. Negotiated Rate	$5,450.04
Rate for Payer: IEHP Medi-Cal	$5,450.04

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$6,993.12

Service Code	APR-DRG 5413
Min. Negotiated Rate	$6,993.12
Max. Negotiated Rate	$6,993.12
Rate for Payer: IEHP Medi-Cal	$6,993.12

Vaginal hysterectomy, for uterus 250 g or less;

Facility OP

$11,807.68

Service Code	CPT 58260
Min. Negotiated Rate	$1,264.72
Max. Negotiated Rate	$11,807.68
Rate for Payer: Aetna of CA Gatekeeper	$5,088.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: AlphaCare Medical Group Medi-Cal	$6,836.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$6,214.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,742.00
Rate for Payer: Dignity Health Commercial/Exchange	$9,321.86
Rate for Payer: Dignity Health Medi-Cal	$6,836.03
Rate for Payer: Dignity Health Senior	$6,214.57
Rate for Payer: EPIC Health Plan Commercial	$9,616.00
Rate for Payer: EPIC Health Plan Medicare	$6,214.57
Rate for Payer: Humana Medicare	$6,214.57
Rate for Payer: IEHP Medi-Cal	$1,264.72
Rate for Payer: IEHP Medicare Advantage	$6,214.57
Rate for Payer: Kaiser Permanente of CA Commercial	$11,807.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,333.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,830.36
Rate for Payer: Molina Healthcare of CA Medicare	$7,830.36
Rate for Payer: TriValley Medical Group Commercial	$6,836.03
Rate for Payer: TriValley Medical Group Senior	$6,214.57
Rate for Payer: Vantage Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: Vantage Medical Group Medi-Cal	$6,836.03
Rate for Payer: Vantage Medical Group Senior	$6,214.57

Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)

Facility OP

$11,807.68

Service Code	CPT 58262
Min. Negotiated Rate	$1,285.80
Max. Negotiated Rate	$11,807.68
Rate for Payer: Aetna of CA Gatekeeper	$5,088.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: AlphaCare Medical Group Medi-Cal	$6,836.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$6,214.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,742.00
Rate for Payer: Dignity Health Commercial/Exchange	$9,321.86
Rate for Payer: Dignity Health Medi-Cal	$6,836.03
Rate for Payer: Dignity Health Senior	$6,214.57
Rate for Payer: EPIC Health Plan Commercial	$9,616.00
Rate for Payer: EPIC Health Plan Medicare	$6,214.57
Rate for Payer: Humana Medicare	$6,214.57
Rate for Payer: IEHP Medi-Cal	$1,285.80
Rate for Payer: IEHP Medicare Advantage	$6,214.57
Rate for Payer: Kaiser Permanente of CA Commercial	$11,807.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,333.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,830.36
Rate for Payer: Molina Healthcare of CA Medicare	$7,830.36
Rate for Payer: TriValley Medical Group Commercial	$6,836.03
Rate for Payer: TriValley Medical Group Senior	$6,214.57
Rate for Payer: Vantage Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: Vantage Medical Group Medi-Cal	$6,836.03
Rate for Payer: Vantage Medical Group Senior	$6,214.57

Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele

Facility OP

$11,807.68

Service Code	CPT 58263
Min. Negotiated Rate	$1,345.34
Max. Negotiated Rate	$11,807.68
Rate for Payer: Aetna of CA Gatekeeper	$5,088.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: AlphaCare Medical Group Medi-Cal	$6,836.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$6,214.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,742.00
Rate for Payer: Dignity Health Commercial/Exchange	$9,321.86
Rate for Payer: Dignity Health Medi-Cal	$6,836.03
Rate for Payer: Dignity Health Senior	$6,214.57
Rate for Payer: EPIC Health Plan Commercial	$9,616.00
Rate for Payer: EPIC Health Plan Medicare	$6,214.57
Rate for Payer: Humana Medicare	$6,214.57
Rate for Payer: IEHP Medi-Cal	$1,345.34
Rate for Payer: IEHP Medicare Advantage	$6,214.57
Rate for Payer: Kaiser Permanente of CA Commercial	$11,807.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,333.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,830.36
Rate for Payer: Molina Healthcare of CA Medicare	$7,830.36
Rate for Payer: TriValley Medical Group Commercial	$6,836.03
Rate for Payer: TriValley Medical Group Senior	$6,214.57
Rate for Payer: Vantage Medical Group Commercial/Exchange	$9,321.86
Rate for Payer: Vantage Medical Group Medi-Cal	$6,836.03
Rate for Payer: Vantage Medical Group Senior	$6,214.57

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$3.84

Service Code	NDC 68084-215-11
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.88
Rate for Payer: Adventist Health Commercial	$0.77
Rate for Payer: Aetna of CA Non-Gatekeeper	$2.64
Rate for Payer: Cash Price	$1.73
Rate for Payer: EPIC Health Plan Commercial	$2.07
Rate for Payer: Heritage Provider Network Commercial	$2.60
Rate for Payer: Heritage Provider Network Senior	$2.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.70
Rate for Payer: LLUH Dept of Risk Management WC	$0.96
Rate for Payer: Multiplan Commercial	$2.88

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$0.98

Service Code	NDC 63304-904-30
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.83
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Gatekeeper	$0.52
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.83
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.54
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.74
Rate for Payer: Blue Shield of California Commercial	$0.61
Rate for Payer: Blue Shield of California EPN	$0.58
Rate for Payer: Cash Price	$0.44
Rate for Payer: Cigna of CA HMO/PPO	$0.64
Rate for Payer: Dignity Health Commercial/Exchange	$0.83
Rate for Payer: Dignity Health Medi-Cal	$0.83
Rate for Payer: Dignity Health Senior	$0.83
Rate for Payer: EPIC Health Plan Commercial	$0.63
Rate for Payer: Heritage Provider Network Commercial	$0.61
Rate for Payer: Heritage Provider Network Senior	$0.61
Rate for Payer: Kaiser Permanente of CA Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74
Rate for Payer: Vantage Medical Group Medi-Cal	$0.83
Rate for Payer: Vantage Medical Group Senior	$0.83

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$0.98

Service Code	NDC 31722-704-90
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.83
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Gatekeeper	$0.52
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.83
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.54
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.74
Rate for Payer: Blue Shield of California Commercial	$0.61
Rate for Payer: Blue Shield of California EPN	$0.58
Rate for Payer: Cash Price	$0.44
Rate for Payer: Cigna of CA HMO/PPO	$0.64
Rate for Payer: Dignity Health Commercial/Exchange	$0.83
Rate for Payer: Dignity Health Medi-Cal	$0.83
Rate for Payer: Dignity Health Senior	$0.83
Rate for Payer: EPIC Health Plan Commercial	$0.63
Rate for Payer: Heritage Provider Network Commercial	$0.61
Rate for Payer: Heritage Provider Network Senior	$0.61
Rate for Payer: Kaiser Permanente of CA Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74
Rate for Payer: Vantage Medical Group Medi-Cal	$0.83
Rate for Payer: Vantage Medical Group Senior	$0.83

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$0.47

Service Code	NDC 0378-4275-77
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.35
Rate for Payer: Adventist Health Commercial	$0.09
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.32
Rate for Payer: Cash Price	$0.21
Rate for Payer: EPIC Health Plan Commercial	$0.25
Rate for Payer: Heritage Provider Network Commercial	$0.32
Rate for Payer: Heritage Provider Network Senior	$0.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.09
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Commercial	$0.35

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$0.98

Service Code	NDC 31722-704-30
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.74
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: Cash Price	$0.44
Rate for Payer: EPIC Health Plan Commercial	$0.53
Rate for Payer: Heritage Provider Network Commercial	$0.66
Rate for Payer: Heritage Provider Network Senior	$0.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$0.98

Service Code	NDC 31722-704-30
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.83
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Gatekeeper	$0.52
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.83
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.54
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.74
Rate for Payer: Blue Shield of California Commercial	$0.61
Rate for Payer: Blue Shield of California EPN	$0.58
Rate for Payer: Cash Price	$0.44
Rate for Payer: Cigna of CA HMO/PPO	$0.64
Rate for Payer: Dignity Health Commercial/Exchange	$0.83
Rate for Payer: Dignity Health Medi-Cal	$0.83
Rate for Payer: Dignity Health Senior	$0.83
Rate for Payer: EPIC Health Plan Commercial	$0.63
Rate for Payer: Heritage Provider Network Commercial	$0.61
Rate for Payer: Heritage Provider Network Senior	$0.61
Rate for Payer: Kaiser Permanente of CA Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74
Rate for Payer: Vantage Medical Group Medi-Cal	$0.83
Rate for Payer: Vantage Medical Group Senior	$0.83

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$0.98

Service Code	NDC 63304-904-30
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.74
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: Cash Price	$0.44
Rate for Payer: EPIC Health Plan Commercial	$0.53
Rate for Payer: Heritage Provider Network Commercial	$0.66
Rate for Payer: Heritage Provider Network Senior	$0.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$0.48

Service Code	NDC 0378-4275-93
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.36
Rate for Payer: Adventist Health Commercial	$0.10
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.33
Rate for Payer: Cash Price	$0.22
Rate for Payer: EPIC Health Plan Commercial	$0.26
Rate for Payer: Heritage Provider Network Commercial	$0.32
Rate for Payer: Heritage Provider Network Senior	$0.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.09
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Commercial	$0.36

VALACYCLOVIR 500 MG TABLET [13133]

Facility IP

$0.98

Service Code	NDC 31722-704-90
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.74
Rate for Payer: Adventist Health Commercial	$0.20
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.67
Rate for Payer: Cash Price	$0.44
Rate for Payer: EPIC Health Plan Commercial	$0.53
Rate for Payer: Heritage Provider Network Commercial	$0.66
Rate for Payer: Heritage Provider Network Senior	$0.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.18
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Commercial	$0.74

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$0.47

Service Code	NDC 0378-4275-77
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.40
Rate for Payer: Adventist Health Commercial	$0.09
Rate for Payer: Aetna of CA Gatekeeper	$0.25
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.32
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.40
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.26
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.35
Rate for Payer: Blue Shield of California Commercial	$0.29
Rate for Payer: Blue Shield of California EPN	$0.28
Rate for Payer: Cash Price	$0.21
Rate for Payer: Cigna of CA HMO/PPO	$0.31
Rate for Payer: Dignity Health Commercial/Exchange	$0.40
Rate for Payer: Dignity Health Medi-Cal	$0.40
Rate for Payer: Dignity Health Senior	$0.40
Rate for Payer: EPIC Health Plan Commercial	$0.30
Rate for Payer: Heritage Provider Network Commercial	$0.29
Rate for Payer: Heritage Provider Network Senior	$0.29
Rate for Payer: Kaiser Permanente of CA Commercial	$0.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.09
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Commercial	$0.35
Rate for Payer: Vantage Medical Group Medi-Cal	$0.40
Rate for Payer: Vantage Medical Group Senior	$0.40

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$3.84

Service Code	NDC 68084-215-11
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$3.26
Rate for Payer: Adventist Health Commercial	$0.77
Rate for Payer: Aetna of CA Gatekeeper	$2.05
Rate for Payer: Aetna of CA Non-Gatekeeper	$2.64
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$3.26
Rate for Payer: AlphaCare Medical Group Medi-Cal	$2.11
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$2.88
Rate for Payer: Blue Shield of California Commercial	$2.38
Rate for Payer: Blue Shield of California EPN	$2.25
Rate for Payer: Cash Price	$1.73
Rate for Payer: Cigna of CA HMO/PPO	$2.50
Rate for Payer: Dignity Health Commercial/Exchange	$3.26
Rate for Payer: Dignity Health Medi-Cal	$3.26
Rate for Payer: Dignity Health Senior	$3.26
Rate for Payer: EPIC Health Plan Commercial	$2.46
Rate for Payer: Heritage Provider Network Commercial	$2.38
Rate for Payer: Heritage Provider Network Senior	$2.38
Rate for Payer: Kaiser Permanente of CA Commercial	$1.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.70
Rate for Payer: LLUH Dept of Risk Management WC	$0.96
Rate for Payer: Multiplan Commercial	$2.88
Rate for Payer: Vantage Medical Group Medi-Cal	$3.26
Rate for Payer: Vantage Medical Group Senior	$3.26

VALACYCLOVIR 500 MG TABLET [13133]

Facility OP

$0.48

Service Code	NDC 0378-4275-93
Hospital Charge Code	1710891
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.41
Rate for Payer: Adventist Health Commercial	$0.10
Rate for Payer: Aetna of CA Gatekeeper	$0.26
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.33
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$0.41
Rate for Payer: AlphaCare Medical Group Medi-Cal	$0.26
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$0.36
Rate for Payer: Blue Shield of California Commercial	$0.30
Rate for Payer: Blue Shield of California EPN	$0.28
Rate for Payer: Cash Price	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.31
Rate for Payer: Dignity Health Commercial/Exchange	$0.41
Rate for Payer: Dignity Health Medi-Cal	$0.41
Rate for Payer: Dignity Health Senior	$0.41
Rate for Payer: EPIC Health Plan Commercial	$0.31
Rate for Payer: Heritage Provider Network Commercial	$0.30
Rate for Payer: Heritage Provider Network Senior	$0.30
Rate for Payer: Kaiser Permanente of CA Commercial	$0.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.09
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Commercial	$0.36
Rate for Payer: Vantage Medical Group Medi-Cal	$0.41
Rate for Payer: Vantage Medical Group Senior	$0.41

VALACYCLOVIR ORAL SUSPENSION COMPOUND 50 MG/ML [4080355]

Facility OP

$0.72

Service Code	NDC 9994-0803-55
Hospital Charge Code	1715245
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

Price Transparency.

All Charges