|
HC CULTURE CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE FOR TB
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$245.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$315.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.46
|
| Rate for Payer: Blue Shield of California Commercial |
$86.98
|
| Rate for Payer: Blue Shield of California EPN |
$69.76
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$298.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Senior |
$10.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$284.12
|
| Rate for Payer: Heritage Provider Network Senior |
$284.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$218.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.61
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10.80
|
|
|
HC CULTURE FOR TB
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$83.08 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$310.74
|
| Rate for Payer: Heritage Provider Network Senior |
$310.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.75
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$237.98 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$88.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$113.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$237.98
|
| Rate for Payer: Blue Shield of California Commercial |
$209.78
|
| Rate for Payer: Blue Shield of California EPN |
$168.26
|
| Rate for Payer: Cash Price |
$90.75
|
| Rate for Payer: Cash Price |
$90.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$107.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Senior |
$26.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$26.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.14
|
| Rate for Payer: Heritage Provider Network Senior |
$102.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$78.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26.07
|
| Rate for Payer: TriValley Medical Group Senior |
$26.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$28.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Cash Price |
$90.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.70
|
| Rate for Payer: Heritage Provider Network Senior |
$111.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.73
|
| Rate for Payer: Heritage Provider Network Senior |
$178.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$141.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$181.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.30
|
| Rate for Payer: Blue Shield of California Commercial |
$72.58
|
| Rate for Payer: Blue Shield of California EPN |
$58.21
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$171.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Senior |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$171.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.42
|
| Rate for Payer: Heritage Provider Network Senior |
$163.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$125.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.78
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.46
|
| Rate for Payer: TriValley Medical Group Senior |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.41 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$188.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$242.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.71
|
| Rate for Payer: Blue Shield of California Commercial |
$67.62
|
| Rate for Payer: Blue Shield of California EPN |
$54.24
|
| Rate for Payer: Cash Price |
$194.15
|
| Rate for Payer: Cash Price |
$194.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$229.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Senior |
$8.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$229.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$218.51
|
| Rate for Payer: Heritage Provider Network Senior |
$218.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$168.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.60
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Senior |
$8.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.89 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Cash Price |
$194.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$238.98
|
| Rate for Payer: Heritage Provider Network Senior |
$238.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.25
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$296.25 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Cash Price |
$217.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$267.42
|
| Rate for Payer: Heritage Provider Network Senior |
$267.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.75
|
| Rate for Payer: Multiplan Commercial |
$296.25
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$296.25 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$211.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$271.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.38
|
| Rate for Payer: Blue Shield of California Commercial |
$62.04
|
| Rate for Payer: Blue Shield of California EPN |
$49.76
|
| Rate for Payer: Cash Price |
$217.25
|
| Rate for Payer: Cash Price |
$217.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$256.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.48
|
| Rate for Payer: Dignity Health Senior |
$7.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$244.50
|
| Rate for Payer: Heritage Provider Network Senior |
$244.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$188.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.71
|
| Rate for Payer: Multiplan Commercial |
$296.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.71
|
| Rate for Payer: TriValley Medical Group Senior |
$7.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.71
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE G.C.
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE G.C.
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$208.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$267.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.55
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$186.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$135.40
|
| Rate for Payer: Heritage Provider Network Senior |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$106.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$137.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.69
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$130.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$123.80
|
| Rate for Payer: Heritage Provider Network Senior |
$123.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE GRAM POSITIVE ID
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912410
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$88.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$113.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.69
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Cash Price |
$90.75
|
| Rate for Payer: Cash Price |
$90.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$107.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.14
|
| Rate for Payer: Heritage Provider Network Senior |
$102.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$78.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
