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Service Code NDC 6954335610
Hospital Charge Code ERX28140
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.14
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Aetna of CA Non-Gatekeeper $0.12
Rate for Payer: Cash Price $0.08
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: Heritage Provider Network Commercial $0.12
Rate for Payer: Heritage Provider Network Senior $0.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.14
Service Code NDC 6025816101
Hospital Charge Code ERX28140
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Adventist Health Commercial $0.05
Rate for Payer: Aetna of CA Non-Gatekeeper $0.16
Rate for Payer: Cash Price $0.10
Rate for Payer: EPIC Health Plan Commercial $0.12
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 $0.17
Service Code NDC 23587901
Hospital Charge Code ERX28140
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.39
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 $0.39
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.25
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 $0.27
Rate for Payer: Cash Price $0.21
Rate for Payer: Cigna of CA HMO/PPO $0.30
Rate for Payer: Dignity Health Commercial/Exchange $0.39
Rate for Payer: Dignity Health Medi-Cal $0.39
Rate for Payer: Dignity Health Senior $0.39
Rate for Payer: EPIC Health Plan Commercial $0.29
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 Commercial $0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
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 $0.39
Rate for Payer: Vantage Medical Group Senior $0.39
Service Code NDC 8770140754
Hospital Charge Code 1711337
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: Cash Price $0.04
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 $0.06
Service Code NDC 8770140754
Hospital Charge Code 1711337
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.07
Rate for Payer: Adventist Health Commercial $0.02
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 $0.07
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.06
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of CA HMO/PPO $0.05
Rate for Payer: Dignity Health Commercial/Exchange $0.07
Rate for Payer: Dignity Health Medi-Cal $0.07
Rate for Payer: Dignity Health Senior $0.07
Rate for Payer: EPIC Health Plan Commercial $0.05
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 Commercial $0.04
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 $0.06
Rate for Payer: Vantage Medical Group Medi-Cal $0.07
Rate for Payer: Vantage Medical Group Senior $0.07
Service Code NDC 7132180230
Hospital Charge Code 1719057
Hospital Revenue Code 259
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.83
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA Non-Gatekeeper $0.76
Rate for Payer: Cash Price $0.50
Rate for Payer: EPIC Health Plan Commercial $0.59
Rate for Payer: Heritage Provider Network Commercial $0.74
Rate for Payer: Heritage Provider Network Senior $0.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.20
Rate for Payer: LLUH Dept of Risk Management WC $0.28
Rate for Payer: Multiplan Commercial $0.83
Service Code NDC 7132180230
Hospital Charge Code 1719057
Hospital Revenue Code 259
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.94
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA Gatekeeper $0.59
Rate for Payer: Aetna of CA Non-Gatekeeper $0.76
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.61
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.83
Rate for Payer: Blue Shield of California Commercial $0.68
Rate for Payer: Blue Shield of California EPN $0.65
Rate for Payer: Cash Price $0.50
Rate for Payer: Cigna of CA HMO/PPO $0.72
Rate for Payer: Dignity Health Commercial/Exchange $0.94
Rate for Payer: Dignity Health Medi-Cal $0.94
Rate for Payer: Dignity Health Senior $0.94
Rate for Payer: EPIC Health Plan Commercial $0.70
Rate for Payer: Heritage Provider Network Commercial $0.68
Rate for Payer: Heritage Provider Network Senior $0.68
Rate for Payer: Kaiser Permanente of CA Commercial $0.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.20
Rate for Payer: LLUH Dept of Risk Management WC $0.28
Rate for Payer: Multiplan Commercial $0.83
Rate for Payer: Vantage Medical Group Medi-Cal $0.94
Rate for Payer: Vantage Medical Group Senior $0.94
Service Code NDC 99006-70043
Hospital Charge Code ERX154771
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Heritage Provider Network Commercial $0.03
Rate for Payer: Heritage Provider Network Senior $0.03
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 $0.04
Service Code NDC 99006-70043
Hospital Charge Code ERX154771
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Gatekeeper $0.03
Rate for Payer: Aetna of CA Non-Gatekeeper $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: Cigna of CA HMO/PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: Dignity Health Medi-Cal $0.04
Rate for Payer: Dignity Health Senior $0.04
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Heritage Provider Network Commercial $0.03
Rate for Payer: Heritage Provider Network Senior $0.03
Rate for Payer: Kaiser Permanente of CA Commercial $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 $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 8770140753
Hospital Charge Code ERX154771
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Adventist Health Commercial $0.02
Rate for Payer: Aetna of CA Non-Gatekeeper $0.05
Rate for Payer: Cash Price $0.04
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 $0.06
Service Code NDC 8770140753
Hospital Charge Code ERX154771
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.07
Rate for Payer: Adventist Health Commercial $0.02
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 $0.07
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.06
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of CA HMO/PPO $0.05
Rate for Payer: Dignity Health Commercial/Exchange $0.07
Rate for Payer: Dignity Health Medi-Cal $0.07
Rate for Payer: Dignity Health Senior $0.07
Rate for Payer: EPIC Health Plan Commercial $0.05
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 Commercial $0.04
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 $0.06
Rate for Payer: Vantage Medical Group Medi-Cal $0.07
Rate for Payer: Vantage Medical Group Senior $0.07
Service Code NDC 5521204010
Hospital Charge Code 1715256
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.16
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Aetna of CA Gatekeeper $0.10
Rate for Payer: Aetna of CA Non-Gatekeeper $0.13
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.14
Rate for Payer: Blue Shield of California Commercial $0.12
Rate for Payer: Blue Shield of California EPN $0.11
Rate for Payer: Cash Price $0.09
Rate for Payer: Cigna of CA HMO/PPO $0.12
Rate for Payer: Dignity Health Commercial/Exchange $0.16
Rate for Payer: Dignity Health Medi-Cal $0.16
Rate for Payer: Dignity Health Senior $0.16
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: Heritage Provider Network Commercial $0.12
Rate for Payer: Heritage Provider Network Senior $0.12
Rate for Payer: Kaiser Permanente of CA Commercial $0.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Vantage Medical Group Medi-Cal $0.16
Rate for Payer: Vantage Medical Group Senior $0.16
Service Code NDC 5521204010
Hospital Charge Code 1715256
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.14
Rate for Payer: Adventist Health Commercial $0.04
Rate for Payer: Aetna of CA Non-Gatekeeper $0.13
Rate for Payer: Cash Price $0.09
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: Heritage Provider Network Commercial $0.13
Rate for Payer: Heritage Provider Network Senior $0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.14
Service Code NDC 71661-009-74
Hospital Charge Code NDG12010B
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.00
Rate for Payer: Aetna of CA Gatekeeper $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO/PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: Dignity Health Medi-Cal $0.02
Rate for Payer: Dignity Health Senior $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Heritage Provider Network Commercial $0.01
Rate for Payer: Heritage Provider Network Senior $0.01
Rate for Payer: Kaiser Permanente of CA Commercial $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.00
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 71661-009-74
Hospital Charge Code NDG12010B
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.00
Rate for Payer: Aetna of CA Non-Gatekeeper $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Heritage Provider Network Commercial $0.01
Rate for Payer: Heritage Provider Network Senior $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.00
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Service Code NDC 24385-070-26
Hospital Charge Code NDG120259B
Hospital Revenue Code 259
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: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare 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 $0.02
Rate for Payer: Cash Price $0.01
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: Multiplan Commercial $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 4110081163
Hospital Charge Code NDG120259A
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 NDC 4110081163
Hospital Charge Code NDG120259A
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 4110081122
Hospital Charge Code NDG120259A
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 Gatekeeper $0.03
Rate for Payer: Aetna of CA Non-Gatekeeper $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
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 $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: Dignity Health Medi-Cal $0.05
Rate for Payer: Dignity Health Senior $0.05
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 $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 24385-070-26
Hospital Charge Code NDG120259B
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: Cash Price $0.01
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 8770140663
Hospital Charge Code NDG120259B
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: Cash Price $0.01
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 4110081122
Hospital Charge Code NDG120259A
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 $0.04
Rate for Payer: Cash Price $0.03
Rate for Payer: EPIC Health Plan Commercial $0.03
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 Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.05
Service Code NDC 8770140663
Hospital Charge Code NDG120259B
Hospital Revenue Code 259
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: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare 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 $0.02
Rate for Payer: Cash Price $0.01
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: Multiplan Commercial $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 299391808
Hospital Charge Code NDG115875B
Hospital Revenue Code 259
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: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare 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 $0.02
Rate for Payer: Cash Price $0.01
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: Multiplan Commercial $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 299391808
Hospital Charge Code NDG115875B
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA Non-Gatekeeper $0.02
Rate for Payer: Cash Price $0.01
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